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bryandental
Canine III

Tracking Pre-Authorizations

Is there a way within the software to mark when Pre-Authoizations have been returned from the insurance company and how much they have estimated to pay?

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3 Replies
kjhogan
Canine III

Re: Tracking Pre-Authorizations

juriz‌ or jeffrey.urkevich‌- can one of you assist?

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mdunham
Premolar III

Re: Tracking Pre-Authorizations

We created a codes that have the abilities to close a claim. We gave them the name "Primary Plan Approved" and "Secondary plan approved", Primary Plan Denied" Seceonday plan denied". I add these into the tx plan with the same group number as the tx on pre-D.   

On the notation within the transaction I would also recommend placing the name of the plan in the check field and the group number., in the notes section I place the Claim number as stated by the ins company.   

I scan the denial/approval, and file secondary if needed.    

This does a few things: 

1: informs TX plan Coordinator very quickly what action

has been made on tx group.  

2.) the code closes a claim, therefore it will delete the claim if you need ( no lengthy pending ins reports) and will also provide opportunity to file the Secondary as well.                

3.). You can them run a report that includes these codes in which you could contact pts.  Perhaps a tx plan report in which you only select those codes that you created as "Approved".     

As far as the need that would show how much was approved/ owed , you would have to

have pred on file and keep accurate Bluebooks and Allowance tables.   

callton
Premolar I

Re: Tracking Pre-Authorizations

Check out this previous discussion:

Tracking pre-determinations