How to Add an Insurance Authorization
The authorization by units and secondary authorizations functionality is currently in limited release to a select group of Members.
Authorization by units and secondary authorizations are only available to Members who use WebPT Billing. Currently, Members who have been enabled for this functionality can input secondary authorizations, however, the authorization will not transfer to WebPT Billing at this time. Primary authorizations will flow into WebPT Billing and attach to the appropriate claims as expected.
The insurance authorization feature allows you to track authorizations for both primary and secondary Insurances by expiration date and the number of visits, or the number of units remaining. Use the following steps to add or edit authorizations in a patient's chart.
Include Authorizations When Adding a New Case
You can add authorization information when creating a new case. In the Patient Info section of the patient chart select Add Case.
- Select Yes in the Authorization Req field, and click OK.
- You will automatically be directed to the Authorization screen.
- Enter the number of authorized Visits and the Effective Start and End Dates. Click Add.
- If you have WebPT Billing/RevFlow:
- Select the insurance (primary or secondary) from the Insurance drop-down. This populates with the insurances listed on the patient's case. Reminder: Currently the secondary insurance authorization does not flow into Billing/RevFlow.
- Enter the Authorization #. This cannot be blank. If you do not have the auth number, you can enter 0000 to bypass the system requirements and allow the authorization to flow into Billing/RevFlow.
- Enter the Effective Start and End dates. Ensure that they do not overlap with any existing authorization on the case.
- Select either Visits or Units and enter the related value in the Number Authorized field.
- Click Add.
Note: If you have more than one authorization on the case, the effective start and end dates cannot overlap. If they do, the system will pull data from the expiring/expired authorization which will negatively impact your reporting and alerts.
Include Authorizations When Editing a Case
- In Patient Info, locate the case. To add or edit an authorization, select the Lock icon.
- Add a new authorization or Edit/Delete an existing authorization.
- Click OK.
- Ensure that you click Save Patient before exiting the Patient Info page.
Authorizations and Billing
Once the authorization has been entered on the case, the Authorization status will appear in the patient chart (SOAP 1.0) or in the Case Summary (SOAP 2.0). When charges are finalized (or addended), the authorization is automatically attached and sent to WebPT Billing or RevFlow based on the criteria outlined in the linked articles. We are working on an enhancement to allow the secondary authorization to flow into Billing and automatically attach to charges.
- When Visit authorizations are entered in SOAP 1.0 they will appear in the patient chart.
- For members using SOAP 2.0, the Authorizations Status will appear in the Case summary.
- When Unit authorizations are entered in SOAP 2.0 the Authorization Status will appear in the Case summary. Note: The unit authorizations are not visible in SOAP 1.0 and are only available to WebPT Billing/RevFlow Members.
Workflows that Impact Authorization Counts
- Do Not Bill Checkbox:
- The authorization count will not change when Do Not Bill is checked on the patient note.
- If an addendum is applied to change the visit from a no-charge to a charge visit the note will update appropriately.
- Authorizations will count the value entered into the Number of visits prior to WebPT on the patient's case towards the overall visits. This does not work for units.
Alerts (SOAP 2.0)
Authorization expiration alerts appear when the patient has two visits remaining, the number of units remaining falls below 10 units, and if the authorization is expiring within 7 days. Authorization expiring and expired alerts display in the Alert Drawer on the Patient records page. Click here for more information on authorization alerts in SOAP 2.0.
Alerts (SOAP 1.0)
Authorization expiration alerts appear when the patient has two visits remaining and if the authorization is expiring within 7 days. These alerts will appear in the At A Glance section on your WebPT dashboard and in the Patient Chart.
Note: The Unit expiration alert is not available to Members using SOAP 1.0. If you use the Unit Authorization you will only see the visit number displayed in the Visits in Case rather than the Visit Authorization. Rest assured the charges will still flow into your WebPT Billing or RevFlow integration.
There are three alert fields relating to authorizations in the At A Glance section. Needs New Authorization, Ending Authorizations, and Expired Authorizations.
Needs New Authorization
Selecting this alert will navigate you to a list of patients that need new authorizations.
Ending and Expired Authorizations
These alerts will navigate you to the Ending Authorizations report. Read more about the report here.
Expired authorizations will display a notification in the patient's chart, indicating the expiration date.
Note: If your new authorization is not updating once entered, verify the authorization was added to the correct insurance and that the dates of authorization do not overlap with the end date on the old authorization.