Changing pre-authorization details

You can view procedures, change billing and rendering provider information, change claim information, and update the status for a pre-authorization.

To change pre-authorization details

1. On the Tx Planner tab of a patient's clinical record, do one of the following:

   • Create a pre-authorization.

   • Click (or tap) Pre-Authorizations to view a list of existing pre-authorizations. Then, click (or tap) the pre-authorization that you want to edit.

     

   The Pre-authorization Detail dialog box appears.

   New or Unsent Pre-authorization

   

   Sent or Queued Pre-authorization

   

   Printed Pre-authorization

   

2. Change the details as needed on any of the following tabs:

   • Procedures

     The Procedures tab displays the associated procedures.

     

   • General

     The General tab displays billing and rendering provider information, the pay-to address, patient information, subscriber information, and payer information.

     

     You can change the Billing Provider and/or Rendering Provider. Only providers who have access to the location where the pre-authorization was created are available.

   • Pre-Auth Info

     The Pre-Auth Info tab displays the name of the Referring Provider, the pre-authorization Reference Number, Orthodontia information (months remaining; and total months, the default value of which is calculated automatically, based on the placement date and remaining months specified, if the pre-authorization was created for orthodontic treatment), the Place of Service for the associated treatment, Accident Information (type, date, and state), and Remarks For Unusual Services (notes for the insurance carrier for this pre-authorization only).

     

     You can enter or change any of this information.

     Note: Only the first 80 characters of Remarks for Unusual Services are submitted electronically even though the box allows up to 151 characters.

   • Attachments

     The Attachments tab, displays the patient's perio exam and the images from the patient's Document Manager that are attached.

     

     You can add and remove attachments if the pre-authorization has a status of Unsent, Queued, Sent, Printed, or Attachment Error:

     • To add an image attachment, click (or tap) Add From Document Manager. In the Add From Document Manager dialog box, select the check boxes of the images that you want to attach, and select a classification/type for each selected image (if necessary, you can change the classification/type later by selecting a different option from the Classification/Type list on the Attachments tab). Click (or tap) Done.

       

     • To attach a perio exam, click (or tap) Add Perio Exam to view a menu that lists the dates of the patient's perio exams, and then click (or tap) the date of the perio exam that you want to attach.

     • To remove attachments, select the All check box to select all the attachments, or select the check boxes of the attachments that you want to remove. Click (or tap) Remove Selected. On the confirmation message that appears, click (or tap) OK. The image is removed from the claim but not from the document manager.

     Notes:

     • The Add From Document Manager button is not available if the payer is a non-supported carrier (a carrier that was manually added to your practice database not from the list of supported carriers that Henry Schein maintains; it has payer ID of 06126).

     • The Add Perio Exam button is not available if the payer is a non-supported carrier or if the patient does not have any perio exams entered in his or her record.

     • Only .jpg/.jpeg files from a patient's document manager are valid for images that you want to attach to pre-authorizations. You can attach only one perio exam to any given pre-authorization. You can have up to a total of 10 attachments per pre-authorization.

   • Status/History

     The Status/History tab, displays the created and sent (if applicable) dates of the pre-authorization and statuses.

     

     You can type a message in the Note field and then click (or tap) Add Note to add a custom status update.

3. Do one of the following:

   • Click (or tap) Save and then Cancel to save and close the dialog box.

   • Click (or tap) Submit to save the changes and submit the pre-authorization.

   • Click (or tap) Resubmit to save the changes and resubmit the pre-authorization.

   • Click (or tap) Print and then OK on the message that appears to create the pre-authorization as a PDF file that you can print.