Prior Authorization Form Enhancement for Behavioral Health
Posted by Sherwin on Friday, 18 March 2016
The way that the prior auth is going to work is that if the patient has no entry. A new entry will be entered into the system. The prior auth can be entered on any encounter. There does not have to be an appointment to enter the prior auth information. It is no long connected only to the encounter where the information was entered. So those that are responsible for entering the prior auth in the system can select any past encounter and enter the information. If there are no past encounters then one will have to be created to enter the information.
Once that entry is made, the system will always look to see if there is a prior auth "on file" for that patient. If there is one then it will be added to the x12_837.
In order to change / update the prior auth, open any encounter and go to the prior auth form and make updates and or changes. The system will record which encounter and date the changes were made but nothing will show visibly.
With the way that many of the insurance companies are requiring that the doctors have a prior authorization on file before services are to be rendered. This form update is a manditory must for those that wish to be paid for providing medical services to patients.
We are continuing the development of the prior authorization form based on the feedback that we are getting from clients input. We are working closely with our clients to build the exact feature rich set that they can use. Our clients told us what something was missing since our last report. There were several items we needed to add.
One being the ability to have an open authorization. So they wanted a check box to denote the open authorization with a designated number of units.
The next thing to be added was the increase in the number of CPT codes that could be active at any given time. There could be up to 7 CPT codes active at any given time. So we increased the number of available slots to meet demand. The desire also for a date range was requested. The date range feature goes with the open authorization feature. This allows the office to set a good till date for the prior authorization.
The new form design is below.