This article reviews how to Create and view Authorizations.
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Add New Authorization
- Click the Clients tab.
- Search client by name.
- Click Search.
- Click Load All Clients to see all clients in the system.
- The client(s) display in the Current Clients section.
- The message No Active Auth displays in the Supervisor column.
- Click the Auth icon. The All Episodes/Authorizations page opens.
- Click Add New Auth. The Episode Module opens.
Enter Episode Information
- Enter a Description.
- It is recommended to enter the payor name followed by the start/end dates of the authorization.
- Enter multiple diagnosis codes if needed.
- The default code, F84.0, displays in the Primary Diagnosis field.
- Enter the On Set Date. It is the same as the auth Start Date.
- Click Create/Save Episode.
- A message displays to confirm the episode was created.
Enter Authorization Information
- Click the Authorization tab.
- Past Auths appear here.
- Click Add New Authorization.
- Select the Payor.
- Select Treatment type.
- All available treatment types display here.
- Enter Authorization Number.
- Enter Insurance ID number of client.
- Select the client's Supervisor.
- Enter Co-Pay if applicable.
- The Copay invoice report pulls from this field.
- Enter Group Number on Insurance Card if applicable.
- Choose file and Upload a copy of the Authorization.
- Enter Start Date of auth.
- Enter End Date of auth.
- Click Save/Add Detail.
- A message displays to confirm the authorization was added.
- After clicking Save/Add Detail, the Activities/Rate section opens.
- It is very important to click Cancel in this section. Users should not manually enter a CPT code here. Manual entry of CPT codes is only done for VERY RARE cases. If billing is processed after a manual CPT code entry, then rates will not pull from the rate list and will show as zero ($0.00).
Enter Activities from Rate List
- Click Activities from Rate List.
- Activities from the Rate List populate.
- Delete any Activities that are not on the Authorization.
- Click Edit to add the units. Do this for each Activity on the Auth.
Enter Units
- Users have the option to enter units per Total Auth, Day, Week, or Month. Click the drop-down menu to see options.
- For example: enter Total Auth on the first line and per day, week or month on the second line.
- Enter the total units per the Auth.
- Users can also drill down and enter units per day, week and month.
- If the Auth number for the activity is different and specific for the CPT code, enter it here.
For example: If the Payor pays 500 on the original Auth number and 540 on another Auth, enter it as 123456,12325465. No spaces, just a comma separating the numbers. - Click Save.
- This rate will appear as 0.00 if users do not want their staff to know the rate. This setting needs to be set up in the rate list. See Enter a Rate List for more information.
- In VERY RARE cases, the Payor may give a lump number of units but does not specify how the units should be used. Enter those units here.
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NOTE: Always contact the Payor to verify there is no breakdown for the units per CPT Code.
NEVER USE BOTH AREAS for entering in units. Either follow steps 1 & 2 or step 6 as listed above.
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- Click Save/Add Detail when done with each Activity.
Copy Episode
Users have the ability to copy an episode to avoid having to enter the same information over again.
- Search for the client and click the Auth icon when the client's information opens.
- Click on the Description for the desired authorization. The Episode tab opens.
- Click Copy Episode.
- Enter new Description (with auth start/end date), On Set Date, Auth Start Date and Auth End Date.
- Click Save.
- A message displays to confirm the authorization was copied successfully.
- Click the Authorization tab.
- Change the Auth number to the new Auth number.
- Delete any Activities that are not on the new Auth.
- Edit the Activities with the new approved units.
- Choose File and Upload a copy of the new Auth.
- Click Save/Add Detail.
Add Placeholder Authorization
A placeholder authorization allows users to schedule and render sessions while waiting for the authorization to come back from the payor.
- Enter a (Tilde sign ~ or Waiting on Auth) in the Authorization number field.
- Check the Placeholder box.
- This allows users to schedule/render the authorization. It will not go to billing until the Placeholder box is unchecked.
- Click Save/Add Detail.
- After the authorization number is received, do the following to ensure all rendered session are sent to billing:
- update/enter the Authorization Number field.
- Update/enter the units for each activity.
- uncheck the Placeholder box
- Click Save
- all sessions that were rendered will get sent to billing
