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What are Enhanced Authorizations?
Enhanced authorizations include additional details such as start and end date, decrementing of total number of authorizations when utilized and exhaustion of authorizations for specified services, requiring the need for a new authorization. This will help to ensure billed services are covered under the approved insurance authorization for your clients.
How will the authorization enhancement benefit me?
- You will be able to add authorizations based on the exact specifications provided by insurance companies.
- You will be able to view how many units or sessions are available for scheduling.
- Appointment authorization alerts will allow you keep track of available sessions or units.
- You have the ability to add authorizations by sessions or units.
- You have the ability to break down authorizations by day, month, week, or entire period.
- You have the ability to filter client authorizations by status (active, inactive, expired & exhausted).
What are the new authorization statuses?
- Active - authorization is not expired and has units or sessions that are still available for scheduling
- Inactive - authorization is tied to inactive insurance
- Expired - authorization is past the expiration date
- Exhausted - all available units/sessions for the authorization have been kept and/or scheduled out in the future, prior to the expiration date.
NOTE: Exhausted authorizations will remain active until the date of expiration or when a client's insurance is no longer active.
Will I get a warning message within an appointment if authorizations are exhausted, expired or inactive?
IMPORTANT: Messaging is disabled by default. To turn on messaging, please navigate to your insurer settings and toggle messaging to on. Learn more.
- Yes, you will get a red warning message if your authorizations are: expired, exhausted or inactive. Learn more
Will authorization reminders be affected if authorizations are exhausted, expired or inactive?
- Yes, reminders will be sent prior to exhaustion or expiration. Learn more
What is happening to my current authorizations?
- Your existing authorizations will be converted to the new format which includes the additional information required for effective authorization tracking. We will flag converted authorizations for review and validation. Note that additional fields, including start date, will need to be validated and updated to properly utilize authorizations features.
- Any new authorizations will require the additional fields to be populated for tracking and decrementing.
How will my authorizations be converted?
- We will transfer any pre-existing information into the converted authorizations such as:
- End Date
- Authorization #
- Sessions allowed
- We will fill in the following info if it is missing from your authorizations:
- Start Date - The date enhanced authorizations become active. Note this will not be the start date of the authorization. This date should be reviewed for any authorizations.
- End Date - We will carry over their end date if one is entered. For authorizations without an end date, we would set the end date to be 12 months from the release date of this new feature.
- Service Types - We will add all service types by default for a converted authorization.
- We recommend that you validate all fields related to the authorization to ensure proper decrementing of units and valid start and end dates.
Where can I go to view, add or edit my authorizations?
- Authorizations that are added will appear in a table in the Bill To and Insurance page of the client under the Insurance Authorizations section. Learn more
Will I need to do anything to these converted authorizations?
- With the added functionality provided by enhanced authorizations, we recommend reviewing any authorizations that have been converted and updating the additional fields with verified insurance authorization information.
- Since a start date was not previously required and the end date was an optional field, we recommend reviewing these dates and making any necessary changes.
- Since service types were not previously required, we recommend reviewing these service types and adding/removing them as needed.
What info is required for creating a new authorization?
- Insurance/Payer
- Type (Units or Sessions)
- Start Date
- End Date
- Services
- Sessions Allowed / Units Allowed (Depending on the selected type)
- Frequency (Only for type = Units)
What other important information should I know about my converted authorizations?
- When converting existing authorizations to the new feature, the system pulled in all service types because the previous authorization feature had no service type qualifiers (it counted any sessions for a client across all services). The service types in the converted authorizations can be edited, if desired, or you can leave them as is. With the new functionality, users can select specific codes for an authorization.
- With the previous functionality, only ‘Kept’ appointments were deducted from the total amount of sessions available in the authorization. As part of the enhanced featured, both ‘Kept’ AND ‘Upcoming’ appointments will now be deducted from the total amount of sessions authorized, in order to prevent over-scheduling an authorization. This may result in your staff receiving notifications from our system that authorizations have been exhausted when your existing authorizations are converted to the new feature.
- With the previously functionality, authorizations were configured in a client's Insurance Details. Authorizations will now have their own section at the bottom of the client's Bill To & Insurance tab in the Insurance Authorizations section.