Authorizations/Prescriptions: Mid-Episode of Care Transition

When transitioning to the WebPT EMR from a different documentation system, authorizations and prescriptions need to be handled carefully for patients already in treatment. Documentation is not imported into the EMR, so the system is unable to calculate the number of past visits on each case, which in turn affects authorization and prescription tracking.

Authorizations

Adding a patient’s case and the related authorization information is relatively simple. However, when a patient is already in treatment, special attention is needed. There are two different scenarios for these patients:

  • Mid-treatment patient on their first/original authorization
  • Mid-treat patient on an additional/subsequent authorization

First/Original Authorization

If the patient’s case is on its first authorization:

  1. On the New Case window, select Yes for Authorization Req. 
  2. Next, enter the number of visits that were documented in the previous system into the “Number of visits this patient has already completed for this case prior to using WebPT” field. 
  3. Click Ok to save the case details. The Authorization window will appear.
  4. Input the auth number into the Authorization # box. If an auth number is not required or you are using authorizations for tracking purposes only, enter a placeholder (i.e. 0000 or Auth on File).
  5. Enter the number of authorized visits into the corresponding Auth Visits field. 
  6. Then, indicate the Effective Start and Effective End dates.
  7. Click Add and then Ok.
  8. Lastly, select Save Patient at the bottom of the page.

The system will automatically subtract the number of prior visits from the number of authorized visits (i.e. 4 authorized visits - 3 prior visits = 1 available visits).

Additional/Subsequent Authorizations

If the patient has already used their original authorization and is using an additional auth:

  1. On the New Case window, select Yes for Authorization Req. 
  2. Next, enter the number of visits that were documented in the previous system into the “Number of visits this patient has already completed for this case prior to using WebPT” field. 
  3. Click Ok to save the case details. The Authorization window will appear.
  4. Input the auth number into the Authorization # box. If an auth number is not required or you are using authorizations for tracking purposes only, enter a placeholder (i.e. 0000 or Auth on File).
  5. Take the number of authorized visits on the current authorization (i.e. 4) and add it to the number of authorized visits used (i.e. 8) from all previous authorizations. Enter the sum (i.e. 12) into the corresponding Auth Visits field. 
  6. Then, indicate the Effective Start and Effective End dates.
  7. Click Add and then Ok.
  8. Lastly, select Save Patient at the bottom of the page.

The system will automatically subtract the number of prior visits from the number of authorized visits (i.e. 12 authorized visits - 8 prior visits = 4 available visits).

Prescriptions

When transitioning a patient during an episode of care, any prescriptions must be entered into the system. The only applies to patients that are in the middle of a prescription.

  1. On the Prescription window, enter the Start Date and End Date.
  2. In the “Number of Visits” field, only enter the number of unused visits. 
  3. Click Add and then Ok.
  4. At the bottom of the page, select Save Patient.

Once recorded on the case, the system will begin tracking the visits. When the prescription is close to ending or expiring, you will receive an At a Glance alert on the Dashboard.