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.
- 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. (Refer to Enter a Rate List > Hide Payor Contracted Rates from Staff).
- 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.
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.
- Click Save/Add Detail when done with each Activity.