FAQ: Authorizations

How will the authorization enhancement benefit me?

• Appointment authorization alerts will help you keep track of available or remaining 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).

Why are authorizations being enhanced? 

• 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.
• You will be able to track utilization of your units/sessions for your authorizations.

What is happening to my current authorizations?

• Your authorizations will be converted to the new format and have a flag to identify they have been converted. Since the authorizations originally were linked to all service types, you may see several service types linked to these authorizations after they are converted. You can easily edit or remove any or all service types that are not applicable from your converted authorizations.
   

  

  
  
  
  
  
  
  
  
  
  
  
   

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
  • 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. You can easily edit or remove all or any not applicable service types from your converted authorizations if needed

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 - You have two options on how to consider authorizations in the Exhausted status.
  • Go to Organizations > Settings tab and select the checkbox for Use Kept and Upcoming appointments to calculate exhaustion for authorizations if you want the number of sessions/units left in an authorization to be based on the difference of the allowed amount of sessions/units minus the appointments that have been scheduled that are in both the Kept and Upcoming status.
    If you uncheck this checkbox,  the only appointments considered will be in the Kept status for the number of sessions/units left. Upcoming appointments will not be considered.

    NOTE: Changing this option will potentially change the status of existing authorizations and may prompt authorization exhaustion reminders to be sent. See Set Up Your Organization's Profile for more information. 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?

• Yes, you will get a red warning message if your authorizations are: expired, exhausted, or inactive. See Client Authorization Status for more information.

Will authorization reminders be affected if authorizations are exhausted, expired, or inactive?

• Yes, reminders will be sent prior to exhaustion or expiration if you have these communication preferences checked under My Profile & Settings > Preferences > General Preferences.  

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)

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.

Will I need to do anything to these converted authorizations?

• Due to the increased 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 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 remaining in the authorization. As part of the enhanced authorizations feature, you can continue to use this functionality by unchecking the Use Kept and Upcoming appointments to calculate exhaustion for authorizations setting under Organization > Settings. However, if you want, both Kept AND Upcoming appointments to now be deducted from the total amount of sessions/units authorized, in order to prevent over-scheduling an authorization, then you will want to select this checkbox.

  NOTE: Changing this option will potentially change the status of existing authorizations and may prompt authorization exhaustion reminders to be sent. See Set Up Your Organization's Profile for more information.

   

• With the previous 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.