Automatic Authorization Approval Setup

Create service authorizations that will be automatically approved.

• These approvals can be single or multiple CPT, revenue codes.
• This form is enabled through the 'Enable Automatic Authorization Approvals' registry setting.

1. ---

   In the Rule Name field, enter the rule name.
2. In the Procedure Code Type field, select the type of code to authorize.
3. In the Code Authorized field, enter the code.
4. In the Is This Rule Active field:

   • Select Yes if the authorization approval rule is active.

   • Select No if the rule is not active.

5. In the Procedure Code Type fields, select the type of code to authorize.
6. In the Code Authorized fields, enter the code, click Process Search to select. Click Ok.
7. In the Maximum Dollar Amount field, enter the maximum dollar amount that can be approved.
8. In the Maximum Expected Liability field, enter the maximum expected liability.
9. In the Maximum Units field, enter the maximum number of units.
10. In the Maximum Duration field, enter the maximum duration (in days) of the authorization.
    Note:This is the number of days from the Start Date to End Date of the authorization.

11. When finished, click Submit.
    Note: The above 'Maximum' fields can be overridden in the Approve/Pend/Deny Rules Definition form ('Overall Lifetime' fields).

► Additional Sections

• Applicable Contracting Provider

► Registry Settings

• Enable Automatic Authorization Approvals

• Status For Auth Requests Partially Covered By An Automatic Auth Rule

• Status For Duplicated Service Requests