Authorization watch is a feature of Therabill that allows you to enter one or more authorizations for one of your patients. The authorization can include a start date, and expire date as well as a count of the number of sessions that are authorized. When creating a claim to the insurance company associated with the authorization (when authorization watch is turned on for the patient) Therabill will alert you when there is no valid authorization for the client. This article will go over how to set up an authorization in Auth Watch for a client.
How to create an authorization for a client
The authorization watch for a client is located in the client record. To get to the client record, click Clients in the top green navigation bar of Therabill. Find the client in your client list and click the edit icon associated with the client. This will open up the client record. At the top right of the client record, under the patient demographics, there is a series of tabs. Click the tab labeled Auths (see image to the right, pointed to by red arrow). You should now see the page shown in the image to the right.
IMPORTANT NOTE: If you are wanting to add an authorization for an insurance company, then you should first enter the insurance card for the client. The insurance companies that are available to you for an authorization come from the insurance cards that you have entered (and saved) for the client. After adding an insurance card for the client, you must save the client in order for the insurance companies to become available. To save the client, click the Save & Edit button at the bottom of the add / edit client form.
Adding an authorization
The add authorization form is on the right side of the auth page in the client record. Here is a description of each of the fields of the authorization.
- Auth Number: This is what will go in to Box 23 of the CMS-1500 as the prior auth number on the insurance claim form.
- Ins. Company: This is where you indicate which insurance company the authorization belongs to. The insurance companies that are available here are pulled directly from the insurance cards that you have entered for the client. You should first enter the insurance card for the patient before you enter the authorization.
- Service Code: This is optional. Only enter a service code if you would like to make the authorization specific to a service code (for example, a CPT code). Therabill will then only use this authorization on claims to the insurance company that use this service code.
- Start date: This is optional. If you want to indicate a date where the authorization begins, then enter this here. Therabill will then only use this authorization on claims to the insurance company that have a date of service after the start date that you enter.
- Expire date: This is optional. If you want to indicate a date where the authorization ends, then enter this here. Therabill will then only use this authorization on claims to the insurance company that have a date of service prior to the expire date that you enter.
- # Sessions: Enter the original number of visits that were authorized.
- Remaining: Enter the number that are remaining as of now. This feature is useful if you are entering an authorization that you have already begun using prior to submitting claims through Therabill.
- Counter Only: If you check this box, then Therabill will not put the authorization number that you enter 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 button underneath the form to save the authorization. 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?
IMPORTANT: This only applies if you turn on authorization watch for the client. You will now see that authorization watch is on for the client by the indicator at the upper right of the auths page. If the indicator is green and reads Turn Off, then authorization watch is on for the client (see image above). If the indicator is red and reads Turn On, then click the indicator to turn authorization watch on for the client.
Submitting an insurance claim to the insurance company on the authorization
Whenever you submit a claim to the insurance company indicated on the authorization, Therabill will perform an error check to make sure that there is a valid authorization to that insurance company. If the authorization has expired (either by expire date or by number of sessions remaining) then Therabill will stop you from submitting the claim until you either 1.) enter a new authorization that is not expired or 2.) turn off authorization watch for the client.
Indicators that authorizations are expiring
You will receive an indicator in your To Do list on your dashboard warning you of authorizations that are soon expiring.
When does Therabill deduct sessions from the Authorization?
If you have authorization watch turned on and you entered that the authorization is limited to # of sessions, then when you create the claim, Therabill will deduct the session from the number of remaining sessions on the authorization.
When I preview a claim, the authorization is not showing in Box 23.
Because Therabill assigns the authorization at the time the claim is submitted, the authorization will not show on the claim preview. You must submit the claim in order for the authorization to go in Box 23.