Managing Authorizations
You can add an authorization when you have a payer and a certification period in place for Certified Home Health. For Private Pay and Fee for Service business lines, the certification period means a time period for services to be provided. Establishing or adding an authorization to a client allows you to schedule resources and begin providing care.
From the client record, click Financial Record, click Authorizations and click Add. Complete the following:
Enter Start and End dates (certification period).
Select Active.
Select Verbal Authorization, if receiving approval from a payer.
Specify Verbal Authorization date, if received.
Verbal Authorization from, indicate name of person who has given approval for authorization.
Mark Status:
Pending - Schedule may be set up, but visits cannot be billed until actual authorization is received.
Not Required - Schedule can be set up and visits billed.
Complete - Authorization is back from the insurance / payer.
Select Patient Plan.
Enter Authorization number.
Click Add and select Case Type.
Select Specialty.
Enter Start and End Dates.
Enter total number of visits to be completed within the start and end date or certification period.
Enter frequency number of visits; per day, QOD, week, QOW, month, year or period.
Add any notes associated with the service provided and click Accept.
Add all disciplines that are providing services to the authorization.
When maximum has been met is checked, visits cannot be scheduled beyond the maximum number of visits entered in the authorization.