Add an Authorization to a Case using Countdown

Use the Countdown on an Authorization

When the Countdown fields are used, a message will be displayed when the Case/Authorization is used on the Scheduling Appointment screen and on the Post/Modify Encounter screen. The fields that are available for countdown are:

• Effective/Expiration Dates
• Number of Visits
• Number of Days
• Dollar Amount
• Number of Units

Add/Modify Appointment Scheduler Screen

• Counts down the number of Appointments left on the Authorization.

• Authorized minus Used minus Future = Remaining

Post/Modify Encounter Screen

• Displays the count down of the fields that were used to set up the case.

• More than one field can be used on the Authorization.
• For instance, an Expiration Date was added and also 6 visits.

• If the Expiration Date is reached before the 6 visits are used, you cannot add anymore Encounters with this Authorization because it has expired.

Add an Authorization to a Case

1. Select the Add Authorization link on the Add/Modify Case screen.

• After Add Authorization is selected, the link will change to Cancel Authorization.

2. Enter the Authorization Number.

Fields used for Authorization Countdown: Complete the following if applicable. (Leave blank if the field does not apply to the Authorization.)

3. Effective Date: Enter an Effective Date to prevent using this Authorization on any Dates of Service prior to this date.
4. Expiration Date: Use to prevent using this Authorization on any Dates of Service after this date.
5. Visits: Enter the number of visits approved for the Authorization.

• Each time an Appointment or Encounter is created, the System will countdown the remaining Visits or Appointments.

6. Dollars: Use to countdown the Dollar Amount approved for the Authorization, such as Medicare for Physical Therapy visits.

• When that dollar amount is reached no more visits can be created with this Authorization.
• A modifier is required (KX) on the second authorization set for max dollars.

7. Days: Use to countdown the number of days assigned to the Authorization.
8. Units: Use to countdown the number of Units for the Authorization.

Additional Information:

9. Rendering: The Rendering Provider this Authorization can be used for can be selected, if applicable.
10. Condition: A Condition can be selected or added if none exists.
11. CPT: Enter CPT(s) that are connected to the Authorization.

• You will need to use at least one of the CPTs on the Encounter for this Authorization to be used.

12. Authorizer: If applicable, enter the person's name who authorized the Authorization.
13. Note: These notes show on the Visit Countdown panel.

Other Fields Panel

14. Other Fields Panel: Select the Plus icon to expand to display the options.

• Complete any applicable fields.

15. Select Save [F2].

Dollar Amount Logic   

Logic for $, Dollar, amount tracking for alerts for any Encounters (Complete & Incomplete) that are linked to the Authorization:

• First it checks any allowed amounts that have been posted and deducts them from the authorized dollars.
• If no payment allowed amounts have been posted, it looks for a loaded contractual allowed fee amount.

If no allowable has been posted and there is no contractual allowed loaded, it uses the charge FEE amount and deducts from the authorized dollars.

No Remaining Authorized Visits/Not Effective for DOS

To indicate there are no remaining visits on an Authorization, the System displays a red-shaded visit count screen.

• When saving the Encounter or Appointment, you will receive a Validation Error or Warning.

• Validation Error Options

• The Encounter can be saved as an Incomplete Charge
• The Encounter or Appointment can be Tagged to work later.
• You can close the Validation pop-up using the X on the upper right corner

• Choose another case or
• Disconnect from the present case.

• Validation Warning Options

• Save and Continue which Saves just as is.
• Close the popup on the Appointment or on the Add/Modify Charge screen.

• If you close the popup, you can make changes before saving again.

Select, Add, or Modify an Authorization

Choose Another Existing Authorization

• Using the Cases dropdown, choose an existing Authorization.

Add a new Authorization number to an existing Case

1. Choose the Case from the dropdown.
2. Select the Modify link.
3. Select the Add Authorization link.

Modify an Existing Authorization

1. Select the Case from the dropdown.
2. Select the Authorization from the dropdown.
3. Select the Modify link beside the Authorization field.

Add a New Case

• From the Case dropdown, select Add New.

View Countdown Authorizations on the Case Dashboard

Patient or Encounter Dashboard > Cases link > select the Case Number

The Case Dashboard shows the Authorization that was created or selected on the Add Appointment screen.

• In the Authorizations panel, the Case will display showing:

• Number of Encounters that are using this Case.
• Effective Date/Expiration Dates if applicable.
• Visits

• How many Encounters that have been billed with remaining to be used.
• How many Appointments scheduled using this Case with remaining left to be used.

• Dollars, Days, and Units work the same as Visits, showing how many have been used with remaining to be used.
• CPTs that have been attached to this Case.
• Notes added on the Authorization.
• Date and Time Added.

• In the Case Appointments panel, the Appointment details display.

• Appointment Date
• Appointment Time
• When (number of days before Appointment)
• Resource Name
• Facility Name
• Type of Appointment
• Reason, if applicable
• Status of the Appointment