Why are there pink visits on the Patient's calendar?
Visits highlighted in pink on a patient’s calendar indicate that the visit is unauthorized. Hovering over the red Thumbs Down icon displays a pop-up message indicating the reason the visit is not authorized.
A visit may have multiple unauthorization reasons. Hovering over the icon shows a single reason at a time. If corrected, then the second reason displays.
The following table provides a list of scenarios, the associated unauthorized visit reason, and a description for each.
|
Scenario |
Unauthorized Visit Reason |
Description |
|---|---|---|
| Exceeds Guardrail Limit | Insufficient Authorization - Guardrails | Visit does not have sufficient authorization because of a monthly guardrail limit |
| Additional Rules | Additional Rules - Failed Validation | Visit fails Additional Rules validation |
| Service Code | Authorization not available with this Service Code | Either missing the service code or the service code is not valid for the Authorization Type |
| No Authorization | Authorization Not Available | No authorization available for the visit |
| Visit Out of Authorized Date Range | Authorization Not Available | Visit falls outside of the visit start and end date |
| Visit less than 15 Minutes | Visit less than 15 Minutes | Visit is less than 15 minutes |
| Blackout Date | Blackout Date | Visit is on the blackout date |
| Daily Period Type Authorization with Time Restrictions | Insufficient Authorization | Visit is scheduled outside of Daily Period Type time restrictions |
| Manual Authorization | Manual Authorization | Manual intervention required due to a manual authorization |
| Missed Visit - Travel Time | Insufficient Authorization | Missed visit Travel Time approval |
| Weekly, Monthly Authorization (Type 1) | Insufficient Authorization | Visit exceeds the allowed Max Units per Period |
| Billing Adjustment to use Authorization Units | Insufficient Authorization | Billing adjustment causes the visit to not have sufficient authorization |
| Daily, Weekly, Monthly Authorization (Type 2) | Insufficient Authorization | Visit exceeds the allowed Max Units for the entire authorization |
|
Primary/Secondary Contract |
Insufficient Authorization | Combined Primary and Secondary contract do not have sufficient authorization for a visit |
| Weekday (Specific Date Type) | Visit cannot be scheduled to start on a Weekend | Visit is authorized for a specific date type (weekday), but the visit is scheduled on the weekend or holiday |
| Weekend (Specific Date Type) | Visit cannot be scheduled to start on (Weekday unless a Holiday) | Visit is authorized for a specific date type (weekend/holiday), but the visit is scheduled on a weekday |