How do I update an internal contract authorization's unit, period, or service code?

Typically, when a payer sends a placement, the system locks all the internal contract’s authorization fields. Providers can set an authorization guardrail for the entire period of authorizations for UPR contracts. This keeps the payer’s mandated authorization limit but allows a provider to subdivide the authorization period totals and use the Additional Rules function.

When a payer sends an Entire Period authorization, the provider can edit the Period field on the Patient Authorization page, as shown below.

Patient Authorization: Editable Period Type

When the provider changes the period type:

  • The system moves the number of units initially shown in the Max Units per Period field to the Max Units for Entire Auth field, as shown below. Max Units for Entire Auth cannot be edited.

  • The provider can edit the Additional Rules checkbox.

    Max Units Per Period, Max Units for Entire Auth, and Additional Rules

The provider can edit Max Units per Period to fit the new Period selected.