Overlapping Billing Authorization Selection

Note: This feature only appears when overlapping authorizations exist for a client. If there is not an overlapping authorization you will not see this feature for your claims.

This can cause confusion during billing and can lead to claim denials. This article covers the new workflow created to select the correct authorization for billing.

Overlaps occur when:

  • Two authorizations exist with different date ranges that overlap (users cannot edit or delete these authorizations).

How to Identify the Issue:

  1. Go to the Billing Visits page and locate the billing exceptions. In the example below, this visit is verified but has a Billing Exception.

    This is a screenshot of the billing visits screen showing a billing exception

  2. Select the Eye Icon to open the visit details.

    Screenshot of the eye ball icon to select to view visit details

  3. Locate the Pre-Auth # field, there is now an option to select the correct authorization for this visit. Use the down arrow to view the authorization options.

    This is a screenshot of the Pre-Auth number drop down for authorization selection

  4. Once selected, the visit will be updated and ready to proceed to billing. A confirmation message will appear to confirm the visit has been updated.

    screenshot of the success box after an authorization is selected

  5. Proceed with billing as you normally would.

Note: Even after the correct authorization has been selected the billing exception will still appear. Proceed with billing using the correct selected authorization.