Printer Friendly PDFUsing the New Insurance Authorization Capabilities
Using insurance authorizations for simple or advanced application to client sessions
Simple authorizations without tracking limits or restricted CPT codes
If you have received an insurance authorization for client sessions and you do not need to track limits or permitted CPT codes, then you can simply enter the authorization in the current insurance policy information (under Client Activity > Contact > Insurance Info > Current Insurance Policy).
Display of authorization in the Insurance Account, with "Show Notes" selected
To view the authorization associated with a session, choose the "Show Notes" option in the Insurance Account layout. The current authorization is entered when either a new session is created or when an existing session is edited. (You can "edit" the session without making changes and the current authorization will automatically be used if none has already been applied to the session.) You can also manually type the authorization into the field on the Insurance Account layout.
Creating an authorization with limits or permitted CPT codes
To track limits or permitted CPT codes for an authorization, use the Current Authorizations subtab. Click on the "Create New Authorization" and you will be prompted to enter the data for the authorization. If a client has multiple insurance policies, the current authorizations are associated only with the insurance policy in use. Different sets of authorizations can be created for different policies.
Prompt to enter data after creating a new authorization
Click "OK" to continue.
Enter the authorization data
A new entry appears in the list of authorizations, with the start date set to the current date. Enter one or more limits (an end date, an allowed number of sessions, an allowed total charge amount). Enter the authorization number. Initially, all CPT codes are permitted in a new authorization.
Set the authorization to "Active"
Check the "Active" box to set the authorization to active. Only active authorizations are applied to sessions. When active, the limits are tracked and status messages provided if warnings are active. (Warnings are set to active by default when an authorization is first made active.) All the sessions since the start date that match the permitted CPT codes are displayed for reference.
Choose permitted CPT codes to use with the authorization
If the authorization applies to certain CPT codes, select the permitted CPT code from the drop down list, then click "Add to List." Repeat to continue adding additional permitted CPT codes to this authorization.
Permitted CPT codes have been applied to the authorization
The permitted CPT codes will be displayed in a list. The sessions list will be updated to display only those with permitted CPT codes.
Adding an additional authorization for different CPT codes
If you need to use a second authorization for different CPT codes, use the "Create New Authorization" button and enter the limit and authorization information. Then, select and add the permitted CPT codes. Set the authorization to active. You can turn the status and warning information on or off as desired.
Authorization display in the insurance policy information
Authorizations created in the "Current Authorizations" subtab will override any that were entered manually in the insurance policy information. If multiple authorizations are active, they will be displayed as a list.
Authorization status information in the Sessions layout
The status of all active authorizations (with warnings turned on) will be displayed on the Sessions layout.
Display for expired authorization
If an authorization has reached or exceeded its limit, the status message will become red. Status messages for expired authorizations will always be shown at the top of the list.
Authorizations applied to sessions can be viewed in the Insurance Account
When new sessions are created or existing sessions edited, the active authorization with the permitted CPT code will be applied to that session. The authorization applied to a session can be viewed on the Insurance Account layout, when "Show Notes" is selected. Active authorization status information (for authorizations with warnings turned on) is also displayed on the Insurance Account layout.
Session on insurance claims are segregated by authorization
For paper claims and electronic claims, when different authorizations have been applied to different sessions within the date range for the report, the sessions are segregated according to the authorization. All sessions with the same authorization wil appear on one claim and only one authorization will be listed on that claim.
A separate claim is prepared for each different authorization
A separate claim is prepared for sessions with a different authorization.