Authorizations

Authorizations are rules that dictate the type, duration, and frequency of the service your Agency can provide a Patient.

The Authorization Type refers to the period used to designate the total number of service hours your Agency can schedule.

It also contains the actual number of permitted hours and the time frame in which those hours may be scheduled as specified by the Payer.

Linked Auth. Daily Period

In comparison, Internal Authorizations divide this information between the Type, Period, and Max columns, as well as the columns designating each day of the week.

Internal Auth. Daily Period

Another key difference between Internal and Linked Authorizations is that the latter only displays the number of permitted hours; units are not used like Internal Authorizations. For example, if a Patient has a Weeklyauthorization type.

Weekly Linked Auth.

If the Payer included Additional Rules, a link appears in the Authorization Type column. Hover the cursor over the link to view any additional rules.

Additional Rules for Auth.

To view a full summary of an Authorization, including any Additional Rules and Notes, click the Authorization Type link Daily, Weekly, Monthly, or Entire Period.

Blackout Dates are cancellations of specific days in an existing Authorization. When a Payer issues a Blackout Date, the specified day(s) turn pink on the Patient’s Calendar indicating that it is no longer authorized. There are two ways to verify if a Blackout Date has been applied to an Authorization, as follows:

  1. In the Notes column of the Authorization line, hover the cursor over the Notepad icon. A pop-up notification appears if a Blackout Date has been applied indicating the cancellation dates with associated notes.

    Blackout Dates Notification

  2. Click the period link Daily, Weekly, Monthly, or Entire Period in the Authorization Type column. The Authorization window contain a section for all Blackout Dates.

    Authorization Window

The Visits/Invoice function is used to refresh Authorizations. This function is required as authorizations are subject to change at any time by the Payer. To run this process, click the Update link in the Visits/Invoice column. Any changes to the authorization, including new Notes and Blackout Dates, are applied and reflected on the Patient’s Calendar.