Prior Authorization Database

SSP Billing includes a prior authorization database with which the software will:

• generate pop-up warnings when a clients units are depleted or a prior authorization number is not on file
• automatically select and insert the correct prior authorization number based on the dates of service
• track the units used and alert you when you are about to exceed the authorized units
• generate reports for actual, authorized and remaining units for an authorization period
• list prior authorizations by expiration dates for renewing authorizations

Each client may have unlimited authorizations for a range of dates of service, Program (department) and Service (procedure). Because you retain these authorization records, re-billing old claims will always use the correct PA number for its dates of service.

Authorization information is entered in the client overview in the Authorizations tab:

When entering claims, clients are checked for a prior authorization and remaining units and warnings are issued if needed:

Services exceeding the allowed units are indicated with an orange units field in the batch:

Printing the batch will also indicate units are exceeded and a prior authorization is not on file:

• Prior Authorization checks can be selectively enabled by program.
• Prior Authorizations can be quickly disabled system wide with a simple configuration change.

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