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Pending Authorization (Procentive)


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  • Updated

Overview

If you are waiting to receive an authorization from a payer, you are able to record a client's services with a pending authorization in the meantime. Procentive will withhold billing any service lines with a pending authorization.
 

Create a Pending Authorization

  1. Go to the Clients Module.
  2. Double-click on the client you want to update the authorization for.
    • The Client window will open.
  3. Click on the Payers tab.
  4. Click on the Authorizations sub-tab.

    pending.authorization.jpg
     
  5. In Request Date: Enter the date you requested the authorization.
  6. In Request Pending: Select Yes.
    • This field is for reporting purposes only. It will not stop claims from going out. To prevent billing claims with a pending authorization, see steps 7.2 below.
  7. Enter the pending authorization as you would typically, with the following exceptions.
      1. Authorization/Date Created: Enter PENDING.
      2. Pending: Check the box. 
        • Procentive will allow service lines that fit the parameters of the authorization to be entered in the Time Module, but the service lines will not enter the Billing Module until the pending check is removed.
  8. Click Save.

 

Complete an Authorization Request Form

  1. Go to the Clients module.
  2. Double-click on the client you want to update the authorization for.
  3. Click on the Payers tab.
  4. Click on the Authorizations sub-tab.
  5. In Request Date: Enter today’s date.
  6. In Request Pending: Select Yes.
  7. Authorization/Date Created: Enter PENDING.
  8. Pending: Check the box.
  9. Click Save.
  10. In Docs, click the black document.

    Authorization_Form_Add.png

  11. Locate the Authorization form you want to complete.
    • If you do not have any Authorization forms turned on in your database, submit a ticket requesting an Authorization form. Provide the Payer name and form name.
  12. Click the radio button Radio button.PNG.
  13. Click OK.
  14. Enter all required information for the form.
  15. Click Save.
  16. Click Print... 

    Authorization_Form.png

  17. Click on the Authorization form title.
  18. Print and submit to payer per instructions. 

 

Convert a Pending Authorization to a Live Authorization

When you receive confirmation from the payer for a pending authorization:

  1. Go to the Clients Module.
  2. Double-click on the client you want to update the authorization for.
    • The Client window will open.
  3. Click on the Payers tab.
  4. Click on the Authorizations sub-tab.
  5. Request Date: Remove the date.
  6. Request Pending: Select No.
  7. Authorization/Date Created: Replace PENDING with the authorization number (if it should travel on the claim; otherwise, leave this field blank.)
  8. Pending: Uncheck the box.
  9. Verify and enter the details and terms of the authorization in the appropriate fields.
  10. Click Save.

NOTE: When the pending authorization is converted to a live authorization, all service lines that have been created with the pending authorization in place will:

  • display the updated authorization number.
  • become available to bill in the Billing Module, Add window.

 

Track a Pending Authorization

The following reports in the Reports Module will allow you to see which clients currently have pending authorizations:

  • Report 3210 Pending Authorizations:  This report pulls information from the Request Date and Request Pending fields.
  • Report 1420 Authorization Detail Report:  This report pulls information from the Pending checkbox.

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