Authorizations are a set of billing codes used to schedule and bill sessions with your clients as well as generating claims to send to the client’s insurance company. All of the authorization files are created in the Files module and their respective codes are pulled from the billing codes page. To begin:
- Navigate to Files and select Create a New Authorization.
- Search for and add a client to the authorization.
- Create a name for the authorization.
- If you have a copy of the authorization file you can upload it by clicking and dragging a file from your computer into the dotted box titled Drop files here to upload, or click on the box to search your computer for a file. Please keep in mind that you can only upload up to 20 files at a time.
- If you do not have a file to upload, select Continue Without a Document.
- Next, choose the payor for this authorization and add the date the authorization becomes active and the date it expires.
- Click Continue & Add Service Codes.
Once the basic authorization information has been added you can then add additional information to the Global Authorization Settings . Here you can store information that would apply to all of the individual codes or group that you’ll add in the next step. If the funding source gives a total amount of hours, units, visits, etc. for all authorized services then you’d enter that here. Also, if a client only accepts a certain amount of those authorized services you can add a separate value to the parent accepts fields.
Below the Global Authorization Settings, you will see three options.
- Single Service Code: for entering an authorized amount for a single code.
- Shared Grouped Codes: for an authorized amount that is shared among a set of service codes.
- Template: when you have already set up at least one authorization template and wish to pull the entire template into the authorization file rather than adding each code individually.
If you select either single service code or shared group codes choice, then you will see this screen .
- General:you can add the authorization number and the client’s diagnosis codes. Adding a diagnosis code here will override the diagnosis code that is stored in the client’s claims settings. If you select Use Service Location it will pull the timesheet’s address/location and place it into the facility address on the claim.
- Service Code(s): click Add service code to search for and add a service code. You can also add an optional note that will show up when scheduling against this set of codes.
- Frequency & Amounts: allows you to set the tracking frequency and the authorized amounts (hours, units, visits, etc) for the codes. The Frequency & Amounts dropdown sets the interval at which the tracking amounts are renewed. For example, if the frequency is set to monthly and the hours field is set to 50, then the authorization code is set to be used up to 50 hours every month. Enter the authorized units per month, week, day, etc in the first row . Enter the total authorized units for the duration of the authorization in the second row . It is good practice to not Allow overbilling unles you’re sure it’s okay for your providers to overutilize the authorized amounts.
- Contacts: you can add some of the information that will pull into future claims. Manager is the employee who is in charge of managing this authorization. Locked for this Provider allows you to add one person who can exclusively use the codes within this authorization. Please see this screenshot to learn which boxes Billing, Referring, Provider/Supplier, and Facility will pull into your CMS-1500 forms. Otherwise, to pull these fields from the default claim settings, leave these blank.
Once you have entered all the necessary and applicable information click Save, or Save and add new to add another set of authorized codes.
This completes setting up an authorization file. You will now be able to schedule an appointment or create a timesheet with the respective client. If the authorized codes don’t show up when attempting to schedule, click here for more information.