Shouldn't the expectation be that the payer communicate the status in real-time and when unable, as soon as a decision is made or need for additional information is determined? Why are there so many references in the guide to having to query for a response? Isn't in the payer's, provider's, and even patient's best interest to not have to query (server overload, wasted time, etc.) Further, are these other potential "askers" like the patient, other members of care team, caregivers covered in specs of this guide? Seems that this guide doesn't gets into these use cases which should be stated if they are being included here.

See section -
Note: There are use-cases for multiple systems potentially needing to check on the status of a pended prior authorization. In addition to the provider who submitted the prior authorization request, the status might also be of interest to: the provider(s) who will be involved in delivering the service for which authorization was sought the patient; the patient's caregivers; other members of the patient's care team.