Authorizations

Files / Authorizations “Cannot Be After Global End Date”

When setting up an authorization of a client, you may receive a Cannot be after global end date  error.

This message simply warns that the end date of the line level authorization code is not matching that of the global end date at the top of the authorization page. To see the end date for the global authorization, simply click Cancel or click outside of the box, and you will see the global authorization settings at the top of the authorization.

 

Files / Authorizations Allowing Overbilling

While creating an authorization, you may want to allow overbilling for frequency amounts such as hours, units, or visits due to make up sessions. However, it is a good practice to not allow over-billing at the group total. To allow overbilling:

  1. Navigate to Files  and open an authorization.
  2. Click on the Authorizations tab.
  3. Click the Edit  icon next to one of the service code groups .
  4. Select the Frequency & Amounts tab.
  5. Under any of your frequencies, click the checkbox  labelled Allow Overbilling.
  6. Click Save.

Note: users with Manage Timesheets permission will still be able to override this setting.

Files / Authorizations Authorization Code Order and Daily Minimum/Maximum

There are certain situations with regards to Authorizations which require one code to be used before another code may be used.  For example, some payors require that 0364T must be used before 0365T may be used.  In this case, you’ll want to use the Enforce Code Order feature.

  1. Make sure you’re on the Authorizations tab within your authorization.
  2. If you’re trying to add a new code group, click Single Service Code or Shared Grouped Codes. If you’re trying to edit an existing group, click the Edit  icon next to that code group .
  3. Navigate to the Service Code(s) tab.
  4. Click the Enforce Code Order button.

This will allow you select the order in which codes must be scheduled and then billed.

Files / Authorizations Authorization Templates

Authorization templates allow you to pre-configure a set of authorizations that can be added to a document or client quickly and easily. To create an authorization template:

  1. Click on Files, then select  Authorization Templates.
  2. Click  Add New to create your new template.
  3. Add a name and an optional description and click Create.
  4. Once created, determine whether this will be a single code or a shared group.
    • 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.
  5. Enter the service code(s), and optionally specify their authorized amounts.
  6. Click Save.

You may add multiple groups and authorized services to this template until finalized. Creating multiple authorization templates can be useful for organizing varying services such as OT, PT, or by payers as specifications will typically be similar. These templates will be available for use when uploading authorizations. Authorization templates will help make the overall authorization process more efficient and consistent for recurring authorizations that are similar or identical.

 

Files / Authorizations Creating an Authorization

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:

  1. Navigate to Files  and select Create a New Authorization.
  2. Search for and add a client to the authorization.
  3. Create a name for the authorization.
  4. 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.
  5. If you do not have a file to upload, select Continue Without a Document.
  6. Next, choose the payor for this authorization and add the date the authorization becomes active and the date it expires.
  7. 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 BillingReferringProvider/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.

Files / Authorizations How do I add a file to an existing authorization

If you proceeded without a document when originally creating a client authorization, you can add the file whenever it becomes available. To do this:

  1. Navigate to the authorization you’d like to upload a document to.
  2. On the File Details tab, click the  0 Previous Versions button.
  3. Click the  Choose a button that appears.
  4. Search for and select the file from your device.
  5. If you wish to override the file name on CentralReach with the name of the file being imported click the checkbox  next to New file name overrides saved file name.
  6. Click the Upload button once you’re ready to upload.

 

 

 

 

 

 

Files / Authorizations How do I set authorization frequencies?

Do you manage your para-staff on a weekly basis, or supervise them monthly? Whatever your current practice, your workflow will designate how to assign and/or group codes. In CentralReach, you have the following options when setting frequencies:

  • Once: use this when you want to enter authorized amounts for the lifetime of the authorization. If you do not want to to break it down by month or week, and simply want to make sure that a code doesn’t go over a certain amount for the life of the authorization.
  • Daily: every day.
  • Weekly: every week.
  • Bi-weekly: every other week.
  • Monthly: every month. This is the recommended tracking frequency.
  • Quarterly: only use this if the authorization valid dates are for a three month period.
  • Semi-annually: Only use this if the authorization valid dates are for a six month period.
  • Annually: Only use this if the authorization valid dates are for a 12 month period.

To change frequencies within an authorization:

  1. Navigate to Files  and open an authorization.
  2. Click on the Authorizations tab.
  3. Click the Edit  icon next to one of the service code groups .
  4. Select the Frequency & Amounts tab.
  5. Click the Frequency & Amounts dropdown and choose a frequency.
  6. Click Save.

Files / Authorizations Managers, Principals, and Locking Auths to a Provider

Administrators may want to give different levels of access to employees when it comes to Authorizations. CentralReach allows an employee to be designated as a manager, a principal, and a provider, but what’s the difference?

  • Manager: Adding an employee as a manager gives that contact access to a specific code within an authorization so that the employee can only see this line level code from the Authorization Report while not necessarily allowing them to use this code. You can add a manager from within any client’s authorization.
    1. Navigate to Files  and select the authorization you want to edit.
    2. Click the Authorizations tab.
    3. Click the Edit  icon next to one of the service code groups .
    4. Select the Contacts tab and add a contact to the Manager field.
    5. Click Save.
  • Principal: Similar to a manager, adding an employee as a principal gives that contact the ability to view not only just the designated service code but all of the service codes within that authorization of a client from the Authorization report. Just like the manager, adding a principal allows that employee to view all of this client’s authorizations.
    1. Navigate to the Contacts  module.
    2. Click on the client you wish to edit, then select the Profile tab.
    3. Click on the  Principals option and click Add New.
    4. Choose a Principal, Principal Type, Start Date, and choose whether or not to hide the principal from other contacts. An end date is optional.
    5. Click Add Principal.
  • Locked for this Provider: When an authorized service code is locked to a provider, it will allow only that employee to use that code within appointments and timesheets.
    1. Navigate to Files  and select the authorization you want to edit.
    2. Click the Authorizations tab.
    3. Click the Edit  icon next to one of the service code groups .
    4. Select the Contacts tab and add a contact to the Locked for this Provider field.
    5. Click Save.