Maintain Authorizations

With the Maintain Authorizations function, you can add, edit, review, print or delete an authorization.

Upon accessing this function, you must first select a patient. If there are any previously stored authorizations on the patient account, the Patient Authorization Record summary screen will list them, starting with the most recent. If there is a case attached to this authorization, it displays in gray color. If not, it displays in black. To select an authorization, click anywhere in the row containing the authorization information. If there are no existing authorizations, then the Maintain Authorizations screen will display containing blank fields.

The Visits Used column reflects the number of visits (dates of service) posted to the account using this authorization number. The Visits Pending column reflects the number of appointments scheduled in the future that are linked to this authorization number. NOTE: This assumes pending status for the current date and calculates going forward from the current date, so the pending visit data will not update until the day after the appointment. If the appointment is scheduled for a Resource, it will not be included in the total.

The Visits Used depend on the number of units entered in the Mlt field on the AUTH procedure code, regardless of how many units are in the Mlt field on the associated procedure. For example, if you enter Proc 99213 with Mlt 1 and Proc AUTH with Mlt 2, the remaining number of visits for this authorization number will be reduced by 2. But, if for example you enter Proc 95117 with Mlt 3 and Proc AUTH with Mlt 1, the remaining number of visits for this authorization number will be reduced by 1.

NOTE: If you forget to enter the AUTH procedure code and have to go back into Change Patient Data and use the Post AUTH Action from the Transaction History screen, you have to select the procedure code that you want the AUTH tied to. The authorization is then automatically created with the number of units that were originally posted with the procedure code. Therefore, if you need to change the number of units on this AUTH, you need to go to Edit a Transaction for the AUTH and change the number in the Multiplier field.

To add a new authorization, click Add an Auth in the Action Column. The Patient Authorization Record screen will display containing blank data fields.

Data Field Information
Prompt Response Req Len
Authorization Number Type the authorization number assigned by the insurance carrier for this patient. 50
Equiv Auth Number Type the equivalent authorization number wich will be the Auth number that is sent electronically and printed on paper claims   50
Effective Date Type the effective date of this authorization or click the calendar icon to select a date. 10
Number of Visits Type the number of visits allowed for this authorization. When you enter appointments, check patients in or out, or post procedures tied to this authorization, CGM webPRACTICE will alert you when the maximum number of visits has been reached.   3
Threshold Visits Type the number of visits you consider as threshold for this authorization. For example, if the authorization allows ten visits, you might want to set the threshold at eight visits. When you enter appointments, check patients in or out, or post procedures tied to this authorization, CGM webPRACTICE will alert you when the threshold has been reached.   3
Maximum Dollar $ Type the maximum dollar amount allowed for this authorization. When you post procedures tied to this authorization, CGM webPRACTICE will alert you when the maximum dollar amount has been reached.   10
Threshold Dollar $ Type the dollar amount you consider as threshold for this authorization. For example, if the authorization allows $1,000.00, you might want to set the threshold at $800.00. When you post procedures tied to this authorization, CGM webPRACTICE will alert you when the threshold has been reached.   10
Termination Date Type the expiration date of this authorization or click the calendar icon to select a date. This field indicates when the authorization expires, regardless of the number of visits allowed or used.   10
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Comment Type any necessary comment text.   45
Insurance Carrier Type the insurance carrier code you want, select a code from the Insurance Carrier list or leave the field blank to not tie any carrier to the authorization. The field defaults to the patient's primary insurance carrier.   5
Contact Name Type the name of the contact person for the insurance carrier. This field will default with the contact name entered for the insurance carrier code but may be changed as needed.   40
Telephone Type the telephone number for the insurance carrier. This field will default with the number entered for the insurance carrier code but may be changed as needed.   20
Case Type the case code you want, select a code from the Case list or leave the field blank to not tie any case to the authorization.   5

After you have saved the authorization, if this patient has any future appointments scheduled they will be listed on the screen. You can tie the authorization number to any appointment in the list by clicking in the row containing the appointment information.

The authorization number will immediately be tied to the appointment.

You can print the authorization by clicking Print in the Action Column on the Patient Authorization Record screen.

You can delete the authorization by clicking Delete in the lower-right corner of the Patient Authorization Record screen. Any previously posted procedures containing this authorization will still retain the authorization number.

To enter an authorization for a patient that has not been registered in CGM webPRACTICE, see Add a Patient Referral which allows you to enter a referral and store the authorization information. The information will be stored in the referral file until the patient is registered and then the authorization information will become part of the registered patient's account.