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 prior 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 prior authorization code for a client:
- Click Patients > Patient name > Billing Settings tab
- Click the Edit icon in the upper right corner of the insurance policy to which you want to add the prior authorization.
- Click the +Add Prior Authorization button.
- Enter the Authorization Code.
- Select a service code (or multiple codes) from the Service Code dropdown.
- Enter the Start and Expires dates, Uses Allowed and Remaining, and select the Usage Setting (Once per Service or Per Unit).
- Enter any additional Comments.
- To add a prior authorization for another service code, click the + Add Prior Authorization button. To remove a prior authorization that you have not yet saved, click the X to the right of the prior authorization.
Tip: If an authorization covers more than one service code, add a separate prior 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 prior authorization to receive care. While prior 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 prior authorization code on claims:
- Click Patients > Patient name > Billing Settings tab
- Click anywhere on the insurance policy to edit the Prior Authorization.
- Next to Status, select the Disabled button.
- Click the Save Changes button.