TAR Professional Service Authorization Defaults

Enter the default values which will be filed with data from myAvatar Cal-PM's TAR Administrative Form.

Avatar MSO > System Maintenance

This form is used for MSO systems with an myAvatar Cal-PM parent application.
An myAvatar MSO Service Authorization will only be created on the first filing of the TAR Administrative Form for finalized TAR records. No edits will be filed to Service Authorizations based on subsequent edits or additions to the finalized TAR record in Cal-PM, therefore, any edits to the Service Authorizations must be entered and filed manually via the Service Authorization form.

In the Funding Source field, select the funding source which will be filed with all Service Authorizations created from myAvatar Cal-PM's TAR Administrative Form.
In the Plan Definition field, select the benefit plan which will be filed with all Service Authorizations created from myAvatar Cal-PM's TAR Administrative Form.
In the Default Blackout Claim Status field, select whether the default behavior for blackout claims should be to Deny or to Pend. This value will be filed with all Claim Processing Blackout entries created from myAvatar Cal-PM's TAR Administrative Form.
In the Default Blackout Claim Status Reason field, select the default reason which will be filed with all Claim Processing Blackout entries created from myAvatar Cal-PM's TAR Administrative Form.
In the Default Authorization Status Reason, field, select the default reason for authorization. This field is enabled and required if any codes in the Current Authorization Status Reason dictionary are associated with the extended 'Current Authorization Status' value of 'Approved'.
In the Default Care Manager field, select the default manager which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.

In the Authorized Level Of Care field, select the level of care which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form, filing for Acute Day TAR record types.
In the 'CPT Code' fields 1-4, specify the CPT codes for Acute Day TAR record types which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.
In the 'Units Per Day' fields 1-4, specify the number of units per day per code for Acute Day TAR record types which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.
In the 'Max Approved Units' fields 1-4, specify the maximum number of approved units per code for Acute Day TAR record types which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.

In the Authorized Level Of Care field, select the level of care which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form filing for Admin Day TAR record types.
In the 'CPT Code' fields 1-4, specify the CPT codes for Admin Day TAR record types which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.
In the 'Units Per Day' fields 1-4, specify the number of units per day per code for Admin Day TAR record types which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.
In the 'Max Approved Units' fields 1-4, specify the maximum number of approved units per code for Admin Day TAR record types which will be filed with all Service Authorizations created from Avatar Cal-PM's TAR Administrative Form.

► SQL Tables

SYSTEM.TAR_auth_defaults
(Holds the high level default information for creating a service authorization from a TAR.)
SYSTEM.TAR_auth_defaults_svc
(Holds the acute and admin procedure codes for creating a service authorization from a TAR.)