Preauthorizations are created and managed from the Treatment Plan module. A preauthorization is very similar to an insurance claim, except that when it is sent, the date of service is left blank. The insurance company reviews the procedures sent and decides whether they are covered under the patient's contract. They will send back a form with an estimate of how much will be covered for each procedure.
Note: The Place of Service for preauthorizations can be edited on the claim. By default, preauthorizations in version 16.4.32 or greater and 17.1.3 and greater inherit the Place of Service from the last procedure in the preauthorization claim. In earlier versions, the first option under Default Place of Service in Practice Setup is used by default.
Create a New Preauthorization
All plans the patient is currently subscribed to will list. To list all insurance plans for the family, including inactive or dropped plans, check 'Show plans for family which are not in use by the current patient'.
Other Coverage: Set other coverage (e.g. secondary coverage) after you create the preauthorization. Open the preauthorization, then at the top of the Claim Edit window, click Change next to Other Coverage. This option can also be used to set primary coverage if this is a preauthorization to a secondary insurance plan.
'Receive' a preauthorization (when it comes back from the insurance company):
The estimates will flow into the patient's treatment plan estimates.
Check Preauthorization Status: Check the status in the upper right of the Treatment Plan module, or use the Outstanding Insurance Claims Report and 'include preauths'.
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