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Track Authorizations by Service Type Overview (My Clients Plus 3.0)


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  • Updated

  Permissions: You must have Billing Permissions. 

In My Clients Plus, you have the ability to track Authorization by Service Type, Units or Sessions. You can receive alerts and/or emails when there are no Authorized Unit left or if the Authorizations is expiring by going to your My Profile & Settings > Preferences > General Preferences and checking the setting for Alert me when authorizations for assigned clients are nearing exhaustion or expiration and Email me when authorizations for assigned clients are nearing exhaustion or expiration.

Before you can track Authorization in My Clients Plus, Service Types must be added by an Organization Administrator.

Additionally, the Client must have an Insurance Payer added to their Bill To & Insurance Info tab as Authorizations are tied to Insurance.

You can add as many Authorizations as needed for each Client. Authorizations and how they are tracked are dependent on how you work with Appointments and Multiple Payers.

 

Authorizations and Appointments

An Authorization is considered used when the Appointment Status is marked as Kept. There are other changes to Appointments that can impact the Authorization Counter:

  • If you delete a Kept Appointment with an Authorized Service, the counter is recalculated. 
  • If you manually change a future Appointment to Kept. 
  • Changing the units defined for an authorized service under Organization Settings > Service Type.

    NOTE: When you are scheduling an appointment for a client that has an authorization entered, you will be able to see how many units you have available.  This counter will update as appointments are scheduled or canceled throughout the authorization period.
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Authorizations and Multiple Payers 

When tracking and billing Primary and Secondary payers:

  • Set the Primary Authorization for the amount authorized by both payers combined.
  • If the Secondary payer authorizes more hours than the Primary you must decide how to enter the hours. The Primary Authorization units should always be set to an amount easily managed.

NOTE: For unit-based authorizations, for service types that bill 1 unit for a certain time interval, units are calculated based on a mid-point rounding system.  The calculated number of units will round up once the midpoint is reached, and round down if the midpoint is not reached based on the length of the appointment. The number of units will never round down to 0. For example: 
If the service type bills 1 unit for every 15 minutes, the midpoint is reached at 8 minutes

  • An appointment from 2:00 - 2:38 PM would round up to 3 units.
  • An appointment from 2:00 - 2:37 PM would round down to 2 units.

If the service type bills 1 unit for every 60 minutes, the midpoint is reached at 30 minutes

  • An appointment from 2:00 - 3:30 PM would round up to 2 units.
  • An appointment from 2:00 - 2:29 PM would round down to 1 unit. 

Next Steps

 

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