This article explains how you can create an authorization or placeholder alongside adding insurance details.
All patients are required to have payor plans (i.e., authorization) in place for scheduling, receiving, and billing services. Insurance companies often provide authorization for specified date spans, as well as approved services and unit limits. TherapyPM offers three authorization management options for providers to assign to their patients, as explained below:
- Active: It is essential for scheduling and billing patient information. It also ensures whether auth is currently valid and suitable for use in the system.
- Group: It allows you to schedule group appointments for multiple patients under one auth.
- Placeholder: It allows patients to have temporary authorization for scheduling and rendering sessions until they receive active authorization. Later, their past sessions will be rendered as ineligible.
How to Create a New Authorization?
- Click the Patient(s) tab in the left navigation.
- In the Patients list, click the patient.
- In the patient info module, click the Ins/ Authorization option. Then, click the "+" icon to add a new authorization.
- In the Add Auth screen, enter the auth information and click the Save Auth button to add a new authorization.
- Auth Status Toggle: You can choose between Active and Placeholder. For active authorization, click on the Active toggle.
Description: Enter a brief description. It is recommended to use the payor name as well as the date range, e.g. "BCBA Assessment 1.1.2021 to 03.01.2021"
Insurance: Select the payor from a list of insurance companies.
Treatment Type: Select the treatment type.
SUPV. Provider: Select a provider from the designated list of supervising providers (if not listed, the provider needs to be marked as Supervisor from the Staffs edit area.)
Date Selection: Select the date range from the pop-up calendar. Ensure the authorization is active during the selected date/date range.
Authorization Number: Provide the authorization number. For non-authorizations, this field will have N/A.
UCI/Insurance ID: Enter the Insurance ID number.
COB: Designate if insurance is primary, secondary, or tertiary.
Diagnosis 1/2/3/4: Enter the diagnosis code 1. For ABA, it is typically F84.0 but you can enter up to four diagnosis codes.
Coins %: Add the co-insurance percentage.
Deductible: Add the insurance deductible.
Copay Per: Choose if CoPay is per CPT code, session, or day.
Copay: Input the Copay amount for the authorization.
Copay Notes: Enter the Copay notes.
Auth Notes: Enter the notes related to the authorization.
CMS 4 (Insured Name): Input CMS 4 details here. The system will fetch this from the Guarantor's First Name and Last Name if it is added.
CMS 11 (Group No): Input the CMS 11 details in this box.
Upload Authorization: Upload the authorization hardcopy or any other auth-related files.
Secondary Insurance: Input secondary insurance.
Secondary UCI/Insurance ID: Enter Secondary Insurance ID.
Secondary Authorization Number: Enter the secondary auth number.
Relation to Insured: Choose the relationship for the secondary insurance from the drop-down option. Even for secondary insurance, the system will use the guarantor details provided in the patient demographics section.
Upload Secondary Authorization: Upload the secondary authorization hardcopy or any other auth-related files.
Save Auth: Save changes finally!
All patients are required to have payor plans (i.e., authorization) in place for scheduling, receiving, and billing services. Insurance companies often provide authorization for specified date spans, as well as approved services and unit limits. TherapyPM offers three authorization management options for providers to assign to their patients, as explained below:
- Auth Status Toggle: You can choose between Active and Placeholder. For active authorization, click on the Active toggle.
Description: Enter a brief description. It is recommended to use the payor name as well as the date range, e.g. "BCBA Assessment 1.1.2021 to 03.01.2021"
Insurance: Select the payor from a list of insurance companies.
Treatment Type: Select the treatment type.
SUPV. Provider: Select a provider from the designated list of supervising providers (if not listed, the provider needs to be marked as Supervisor from the Staffs edit area.)
Date Selection: Select the date range from the pop-up calendar. Ensure the authorization is active during the selected date/date range.
Authorization Number: Provide the authorization number. For non-authorizations, this field will have N/A.
UCI/Insurance ID: Enter the Insurance ID number.
COB: Designate if insurance is primary, secondary, or tertiary.
Diagnosis 1/2/3/4: Enter the diagnosis code 1. For ABA, it is typically F84.0 but you can enter up to four diagnosis codes.
Coins %: Add the co-insurance percentage.
Deductible: Add the insurance deductible.
Copay Per: Choose if CoPay is per CPT code, session, or day.
Copay: Input the Copay amount for the authorization.
Copay Notes: Enter the Copay notes.
Auth Notes: Enter the notes related to the authorization.
CMS 4 (Insured Name): Input CMS 4 details here. The system will fetch this from the Guarantor's First Name and Last Name if it is added.
CMS 11 (Group No): Input the CMS 11 details in this box.
Upload Authorization: Upload the authorization hardcopy or any other auth-related files.
Secondary Insurance: Input secondary insurance.
Secondary UCI/Insurance ID: Enter Secondary Insurance ID.
Secondary Authorization Number: Enter the secondary auth number.
Relation to Insured: Choose the relationship for the secondary insurance from the drop-down option. Even for secondary insurance, the system will use the guarantor details provided in the patient demographics section.
Upload Secondary Authorization: Upload the secondary authorization hardcopy or any other auth-related files.
Save Auth: Save changes finally!