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Service Authorization Request

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Enter a request for a service authorization.

myAvatar MSO > Care Management > Service Authorization Request

Prerequisites:

  1. In the Select Client screen, enter the client name, click Select Client Name. Click Ok.

  2. Click Brief Member Review to generate the Brief Member Review Report, that details the member's diagnosis and treatment information for EOBs in the last 180 days.

  3. Click Member Authorization History to generate the Member Authorization History report, that details the member's previous service authorizations.

  4. In the Type of Authorization field, select the authorization type.

  5. The Authorization Number field displays the service authorization number.

  6. In the Funding Source Authorization Is For field, select the funding source.

  7. The Benefit Plan field displays the assigned plan.

  8. In the Provider To Be Authorized field, enter the provider name, and select.

  9. In the Performing Provider field, select the facility member.

  • If the performing provider associated with the service is different then the provider in the authorization, the service will be denied.

  1. In the Performing Provider Type field, select the provider type (setup in the Contracting Provider Registration form).

  1. In the Planned Admit Date field, enter the planned admission date.

  2. In the Authorized Level of Care field, select the level of care.

  3. In the Current Authorization Status field, select Approved if this authorization has been approved.

  4. In the Current Authorization Status Reason field, select the authorization status reason.

  5. In the Account field, select the budget tracking account.

  6. In the Initial or Continuing Authorization field, select Initial if this is the member's first authorization.

  • Select Continuing for an additional member authorization.

  • Select Copy to copy information from an authorization to the current authorization.
    If Copy is selected, the Authorization Listing screen displays. Select the service authorization, click Ok.

  • The authorization end date populates the Begin Date of Authorization field.

  1. In the Begin Date of Authorization field, enter the authorization begin date.

  2. In the End Date of Authorization field, enter the authorization end date.

  • Services claimed after this date will be denied.

  1. In the Next Review Date field, enter the review date.

  2. In the Authorization Grouping or Individual Authorizations field:

  • Select Grouping to select a Service Authorization Group.

  • Select Individual to select an individual service.

  • Select All to authorize all CPT procedure codes and revenue codes.

  1. In the Authorization Grouping field, select the authorization grouping.

  2. Click Display Authorization Grouping to generate the Authorization Grouping Definition report, which details authorization grouping information.

  3. The Total Estimated Liability field displays the total liability codes, for the authorized service codes.

  4. In the Letter Type field, select the letter type.

  5. In the Procedure Code Type fields, select CPT Code for CPT code services. Select Revenue Code for revenue code services.

  6. In the Code Authorized fields, enter the CPT or Revenue Code, and select.

  7. In the Requested Units fields, enter the number of units requested.

  • These fields are enabled when Yes is selected in the Member Authorizations Contain Unit Limitations field (Funding Source Registration form).
  • If an authorization has claimed services against it, the procedure code for associated services cannot be edited or deleted.

  1. When finished, click Submit.