Authorization Watch

The Authorization Watch feature allows you to enter one or more authorizations for your clients. When turned on, the system alerts you when trying to create a claim that does not have a valid authorization attached.

Important: Authorization Watch must be turned on for the feature to work. If you have an authorization for an insurance entered, but the feature is turned off, the system will not run an authorization check when submitting claims for that client.

Turn On Authorization Watch

1. Navigate to Clients > Client List.
2. Locate the desired client and edit their chart using the icon.
3. Click on the Auths tab in the center row of the screen.
4. Click the red Off button to turn on the Authorization Watch. The button will turn green and be labeled On - stating that this feature is active.

Adding an Authorization (Standalone)

The Add Authorization form is on the right side of the screen. Here is a description of each of the fields of the authorization.

• Auth Number: This will go into Box 23 of the CMS-1500 as the Prior Authorization Number.
• Ins. Company: This is where you indicate which insurance company the authorization belongs to. The insurance companies that are available are pulled directly from the client's chart.
• Service Code: This is optional. Only enter a service code if you would like to make the authorization specific to a CPT code. The authorization will only be used on claims to the insurance company that contains this service code.
• Start date: This is optional. The system will only use this authorization on claims to the insurance company that has a Date of Service after the start date that you enter.
• Expire date: This is optional. The system will only use this authorization on claims to the insurance company that has a Date of Service prior to the expiration date that you enter.
• # Visits/Units: Enter the original number of visits or units that were authorized.
• Remaining: Enter the number that is remaining as of today. This feature is useful if you are entering an authorization that you have already begun using prior to submitting claims through the system.
• Counter Only: If you check this box, then the system will not put the authorization number on the claim form. You can use this to create an authorization that is only used internally at your clinic.

Once you have finished, click the Add Authorization to save the information. You will now see the authorization on the left-hand side of the Auths page. You can edit or delete the authorization using the edit icon  and delete icon  associated with the authorization.

What does the authorization and authorization watch do?

Claim Submission Error

Whenever you submit a claim to the insurance company indicated on the authorization, the system performs an error check to make sure that there is a valid authorization to that insurance company. If the authorization has expired (past the expire date or zero visits remaining) then an error will generate. Additionally, this error can occur if an authorization is not attached to a session.

To remedy the error you can:

• Add a new authorization
• Attach an existing authorization
• Turn off Authorization Watch

Indicators that authorizations are expiring

If you have the authorization alert activated for Things To Do, you will receive a dashboard warning that will show authorizations that will be expired soon or have a limited number of visits remaining.

When does Therabill deduct sessions from the authorization?

When Authorization Watch is turned on and a claim is created, the system will deduct the visit/units from the number remaining on the authorization. If you create a claim for a session that has previously been submitted with that authorization, there will be no deduction unless new units have been added to the session (for unit-based authorizations).

When I preview a claim, the authorization is not showing in Box 23.

The system assigns the authorization at the time the claim is submitted, so the authorization will not show on the claim preview. You must submit the claim in order for the authorization to be seen in Box 23.