Entering Authorizations.

Yes:

• Used when an authorization has been received

Pending:

• Used when you are waiting to receive an authorization but need to schedule appointments

Not Needed:

• Used when a funder does not require an authorization. Can enter information in based on clinician recommendations

• Authorizations marked as 'pending' allow scheduling to occur against the auth, but the appointments on the scheduler will display in Orange to indicate the pending status

• Appointments completed with a pending auth will also show on the Billing report with this Pending status in the Validation column:

• Once the client's authorization is updated to 'yes' for received, then all of the appointments will update to green in color on the scheduler and there will no longer be the validation warning in the Billing Export.  

• If your funder does not require an authorization; you can mark it as "Not Needed"

  • Tip: Although a funder may not require an authorization, it is important you have a way to track treatment utilization to ensure the client is receiving the recommended number of treatment hours set by your clinicians

Type in the Authorization Number 

• If an authorization is Pending: Type in the pending authorization number or a placeholder

• If an authorization is Not Needed: Type in something such as "Not Needed"

  • It is not recommended to input a fake number or "N/A" as you could see issues later with billing 

Enter the Start and End Date range of the authorization 

• If an authorization is Pending: You can input the dates requested from the funder

• If an authorization is Not Needed: You can input dates for a recommended re-evaluation, for example.

Select the Rendering Provider - This will dictate what you see in the Rendering Provider Name and Rendering Provider NPI # columns in the Billing Export

• Agency: Will generate only group information in columns AP - AS of the billing export report

• Provider Assigned to the Appointment: Will list the provider who physically performed that service during that session

• The name of the supervising BCBA: Will list the selected BCBA as the rendering provider despite if another employee performed the service

Optional: Referring Provider

• If a referring provider is required to be submitted on box 17 of the CMS-1500 form for claims, they can be listed here. 

• By Service: Used if you receive an authorization that puts parameters around how many units can be used per billing code (Recommended)

• By Authorization: Used if you received a lump sum Authorization that does not specify hours by service. You will be prompted to enter the Total # of units for all services (Not recommended as Rethink cannot prevent exceeding authorized hours if units are distributed by authorization)

• Add multiple services to the same authorization by clicking Add Service to add individually, or Add All Services to add all service names under the client's funder

• Optional: The Scheduling Goal allows you to target a specific intensity of service that is different from what has been authorized. For example, if the family does not accept all of the authorized hours

  • You will receive a soft warning if/when exceeding the scheduling goal but you will still be allowed to save those appointments

You can view authorization details from the client authorization home page. 

Edit:

• Allows you to adjust values on the current authorization such as authorized units, dates, rendering provider, etc.

Upload:

• Allows you to select a file from your computer to upload to the authorization.

Copy:

• Allows you to copy the existing authorization details to create a new authorization. Once copied, updates can be made for any changes.

Delete:

• If an authorization has not be utilized and scheduled against, you will be able to delete the authorization

  

  . If scheduling has occurred against the authorization, you would be unable to delete and the recommendation would be to term the authorization by adjusting the end date.

• The system will not allow you to end date the authorization if future appointments exist for this authorization nor will you be able to reduce the units below what is already scheduled: