Budget Fields in Patient Authorizations for Linked Contracts

For certain Linked Contracts, Budget fields, Program Code and Budget Amount(s), have been added to the Patient Authorization window. These fields are requested by Payers who support certain programs and are read-only for Providers.

Member Authorization: Budget Fields

The budget fields are editable when Providers create the Authorization and read-only when the Authorization comes directly from the Payer.

Field

Description

Program Code

Some Payers use their own Program Codes to identify Members using certain programs. Members can have multiple Authorizations with a different Program Code for each or the same Program Code for all Authorizations.

Budget Amount ($)

Some program Members are assigned a budget dollar amount (rather than units) to determine the services provided. The Budget Amount ($) field is used for the total budget dollar amount.