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mdunham
Premolar III

Tracking Pre-Authorizations

I have had several offices ask me how to track Pre-Ds.  The answer is simple.  Create a code in the 2 range.  I have several-  2.12 Pre-authorization Primary                           9999998-  Pre-auth Submitted

              2.13 Pre-Authorization Secondary

             2.14 Denial of Pre-auth of Primary

            2.15- Denial of Pre-auth of Secondary   

  The use of the code range 2 will CLOSE any claim attached to it.  Therefore you will not need to go back and delete or pre-d claims when they have been received.    I enter these codes into my tx plans with the same group number as the treatment.   Within the transaction, I suggest adding the plan name in the check number box and the Group number in the Bank number box, this way it easy to see what plan and group pre-d/denied the tx.  It is an easy way to reference information rather than searching in doc tree/ chart for pre-D claim information.  

The code 999998 Pre-auth Submitted is simply a notification to us showing that a tx plan was sent for pre-d, so that our team does not have to assume or look for pre-d claim.  

I hope this helps offices who have a large amount of pre-d claims in their Outstanding claims report.