The Patient Referral Authorization Number is the key field that identifies the patient referral authorization information including the referring provider, referred to provider, treatment start and end dates, associated procedure codes and diagnosis codes, if applicable.
Entry Options:
If the insurance carrier has issued the Authorization Number, enter the Authorization Number assigned to the referral.
If you do not yet have a number from the insurance carrier...
Leave the Authorization Number blank or enter zero (0), and the system will generate a temporary number.
Or, enter your own temporary Authorization Number.
Notes:
The Patient Referral Authorization Number is a separate field from the Patient Prior Approval Number. The Prior Approval Number is maintained during the Patient Entry - Workers' Compensation Window.
Some insurance carriers must assign a referral Authorization Number before services are provided to the patient. If a referral authorization is not obtained for the services provided, the insurance carrier may decline provider reimbursement of the submitted claims. For additional information, contact the individual insurance carriers for their Prior Approval/Authorization requirements.
You can later change the temporary number to the insurance's Authorization Number.
If you use a temporary Authorization Number, you must set the Referral Status to (P)ending.
Where-Maintained: Patient Entry at the Referral Authorization Window or the Change Authorization Number Window
Format: up to 15 characters. Required. Usually assigned by the Insurance Carrier.