How To: Add Pre-Authorization Codes

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Most insurance providers do not require mental health services to have a prior authorization. However, for those that do, TherapyNotes offers a convenient feature to ensure that any required pre-authorization information is included on claims.

TherapyNotes counts down the number of remaining uses when the claim is initially submitted electronically or a CMS-1500 is generated through TherapyNotes.

Role Required: Practice Biller or Biller for Assigned Patients Only

To add a pre-authorization code for a client:

  • Click Patients > Patient Name > Billing Settings tab
  • Click anywhere on the Pre-Authorizations box to edit

preauthorizations.png

  • Select a service code from the Service Code dropdown
  • Enter the Authorization Code, Parameters, and any additional Comments
  • To add a pre-authorization for another service code, click the Add Pre-Authorization button. To remove a pre-authorization that you have not yet saved, click the X to the right of the pre-authorization
Quick Tip: If an authorization covers more than one service code, add a separate pre-authorization for each service code you intend to bill.
  • Click the Save Changes button

If a client's insurance provider or health plan changes, they may no longer need pre-authorization to receive care. While pre-authorizations remain in a client's chart to assist you with disputing a claim if needed, you can prevent them from being included on future claims.

To stop including a pre-authorization code on claims:

  • Click Patients > Patient Name > Billing Settings tab
  • Click anywhere on the Pre-Authorizations box to edit
  • Enter a date in the past in the Expires field
  • Enter 0 in the Uses Remaining field
  • Click the Save Changes button
Have more questions? Submit a request

Comments

  • Avatar
    Brad Larsen Sanchez

    Can the system alert us to renew the authorization based on the date rather than the number of sessions?

  • Avatar
    Jordan

    Brad,

    Thank you for the suggestion. I will pass this along to development as a possible future feature request.

  • Avatar
    Erin Rosenberg

    Even though I entered the prior auth number in the Patient Billing tab, it is not automatically being pulled through on the EDI form. How can I get that prior number to show up?

  • Avatar
    Jordan

    Erin,

    I'm going to personally reach out to you regarding your pre auths not pulling through on EDI claims. Thank you!

  • Avatar
    Marco Cuyar

    Even though I entered the prior auth number in the Patient Billing tab, it is not automatically being pulled through on the EDI form. How can I get that prior number to show up?

  • Avatar
    Jordan

    Marco,

    We will reach out to you regarding this. Thank you!

  • Avatar
    Dee Lohmann

    How can I set an alert when the authorization is down to 4 visits left?

  • Avatar
    Jordan

    If you enter a pre-authorization code in the patient billing settings, it will count down automatically if you submit the claim via EDI. If you submit a claim manually (cms-1500) you will have to manually count down the number of appointments for Pre-authorizations.

    In the billing settings tab on the top left hand corner If you put in a set number of appts, it will let you know when there is 1 or 0 left when scheduling the apt. We do have this feature pending for pre auths.

  • Avatar
    Carla Kingston

    I have some authorizations that cover multiple billing codes - they are "open auths" and cover any billing codes that are in my contract. How can I manage those?

  • Avatar
    Jordan

    Go to "billing settings" within the patient chart and under the header "Pre-Authorizations" click on the blue button "+Add Pre-Authorizations" this will give you the option to select a service code. If you click the same button it will give you another option to select a service code. You will be able to enter in the Authorization code, expiration date, uses allowed/remaining, and any comments.

  • Avatar
    George Renz

    Is there any way to search across patients by Pre-Authorization Code? Some payers (E4 Health, for example) only include their "referral #" (pre-auth. code) on the check stub, with no other indication of who the patient is. Being able to search that way, or perhaps run a report based on it, would make allocating those payments much easier. And since TN doesn't alert the clinician when they need to request more visits, such a report would also be extremely useful if it included not Patient Name and Pre-Auth. Code, but also dates and # of visits authorized/remaining.

  • Avatar
    George Renz

    That was supposed to say "such a report would also be extremely useful if it included not only Patient Name and Pre-Auth. Code...."

  • Avatar
    Laura

    George,

    Unfortunately there is not a way to search across patients for Pre-Authorization codes. I apologize for the inconvenience. I will forward your suggestion to management for review.

  • Avatar
    Jennifer Smith
    I would like to remove the authorization code once that code is no longer needed (when the client has used their EAP visits and switch over to their traditional insurance plan). How do I remove the authorization code?
  • Avatar
    Jordan

    Jennifer,

    I will have an agent reach out to you regarding this as there is specific information we will need. Thank you.

  • Avatar
    Nicola Barnes

    We have entered pre-auth codes on the billing but they are not showing up on the CMS-1500 form.

  • Avatar
    Laura

    Nicola,

    A support team member will contact you directly about this issue.

  • Avatar
    Laura Bryan

    Is there a way to delete a duplicate pre-authorization code entry?

  • Avatar
    Laura

    Laura,

    There is not a way to delete pre-authorizations. As a workaround:

    1. Change the expiration date to some time in the past.
    2. Change the "Uses Remaining" to 0.
    3. Click the green "Save Billing and Insurance Settings" button.

  • Avatar
    Mary Kay Carstensen

    Is there a way to get a warning when the authorized visit count is down to 4? That will give us enough time to renew the authorization if necessary.

  • Avatar
    Laura

    Mary Kay,

    We plan to add pre-authorization warnings in the future, but do not have an ETA at this time. Thank you for your feedback!

  • Avatar
    Natalie Benham

    Pre-authorization warnings would be very helpful.

  • Avatar
    Jordan

    Natalie,

    Thank you for your suggestion! I will forward your feedback to management for review. If you have any questions please contact support at 215-658-4550. Thank you.

  • Avatar
    David Johns

    April 06, 2016 10:41

    Laura,

    There is not a way to delete pre-authorizations. As a workaround:

    1. Change the expiration date to some time in the past.
    2. Change the "Uses Remaining" to 0.
    3. Click the green "Save Billing and Insurance Settings" button.

    THIS IS A PROBLEM!! MY CLIENT CHANGED INS COMPANIES AND I DONT NEED PREAUTHS SHOWING UP ON 1500 forms!!

  • Avatar
    Jordan

    David,

    I will reach out to you in regards to your inquiry above. Thank you.