Add Cases and Authorizations

Add a Case and Authorization/Referral

Idea

Cases can be added in multiple places in the System. Select this link: Cases and Authorization Overview.

Case Panel
  1. Type: Choose from the dropdown or add your own by choosing Manage (See below for adding Case Types). Used for Reporting purposes.
  2. Description: Enter a meaningful naming convention for the description, such as DOI, Location, and Authorization type. This displays in the Appointment screen.
  3. Active: If Active is checked, the Case is available to use in Encounter entry and Scheduling.
  4. Default: If Default is checked, all New Encounters and appointments will auto-select this Case, but can be manually overridden).
  5. Insurance Profile: Assign the correct Insurance profile to this Case.
  6. Case Number: System defaulted

Case Facts/Charge Default Panel

Cause/Accident Information

  1. Cause: Used mostly for specialties, such as Therapy, Chiro, and OB. Choose one of the following:

    • Illness (L): 431 Onset Date

    • Injury (I): 454 Initial treatment date

    • Pregnancy (P) 484 LMP date

  1. Date of Current:

    • Use in conjunction with Cause.

    • For Illness, enter the onset date.

    • For Injury, enter the initial treatment date;

    • For Pregnancy, enter the LMP date.

  1. Accident:

    • For Employment see Worker's Compensation Cases.

    • For an WC, Auto Accident (MVA), or other Accident, select the Accident button to access the popup (includes date, cause and state).

    • Only one Cause needs to be used except for a few exceptions.

      • Example: If an employee has an auto accident while on the job, Related Cause 1 would be Employment and Related Cause 2 would be Auto Accident.

  2. Learn More: Related Causes

  3. Facility, Assigned Provider, Referring Doctor, and Ordering are optional.


  1. Diagnoses are optional.

  1. If the Dx1 field is mandatory (yellow) ask your System Administrator to make the field Not Mandatory.

Add an Authorization from the Case

  1. Click the Add Authorizations link to enter the Authorization details. (Authorization Number: Displays in HCFA Box 23/ANSI Loop 2300.)
  2. Enter the Authorization Number.
    1. Primary Authorization Number: Leave blank if there is no Authorization because it will cause Claims to reject if anything else is entered here.
    2. Secondary and Tertiary Authorization Numbers: Occasionally, a Secondary or Tertiary payer will need an Authorization Number. If these fields are left blank, the System automatically sends the Primary Authorization number.
  3. For Visit Countdown and displaying alerts on the Appointment Scheduling screen and Post/Modify Charge screen, enter any of the following limiting factors: Effective/Expiration Dates, # of Visits, Dollars, Days, Units, Rendering, and CPT® Code(s).
  4. Authorizer: Free form field for the applicable Authorizer. You can use the Contact on the Case if you prefer.
  5. Note: Displays in the Authorization dropdown.

Other Fields Panel

Info
HCFA 11b pulls from the Other Claim ID box.
  1. Other Fields: To access, click the plus icon (+). Depending on your Specialty, some of these fields may be beneficial for informational purposes.
  2. Click Save(F2).


Add an Authorization to an Existing Case on the Modify Charge Screen

  1. On the Modify Charge screen from the  Authorization dropdown, select Add New.


  1. Complete the applicable fields.
  2. Click Save [F2].




Add A New Case Type 

  1. On the Add/Modify Case screen, select Manage from the Type dropdown.

  1. Select the Add button.
  2. Code: Enter a 1 or 2-digit code.
  3. Enter a Description.
  4. Select Save [F2].


                  

  1. Close the window.

  1. From the Type dropdown, select the Type that was added.

      


Learn More

  1. Delete a Case

  2. OB/GYN Billing Specifics

  3. Workers Comp Cases

  4. Chiropractic

  5. Add a Referral

  6. System Settings

    1. Default Accident State

    2. Case Default


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