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The Authorizations tab on the Insurance Maintenance window enables you to enter one or more authorizations for the patient's insurance. For example, a provider may need to obtain an authorization from the payer prior to performing a specific procedure for the patient. The authorization number provided by the payer can be entered in NextGen® Enterprise PM, so it is included in the claims sent by the provider to that payer for the authorized procedure.
A pushpin icon on the tab indicates one or more authorizations exist for the patient's insurance.
Existing authorizations are listed with the following information:
If you have selected a service package library in field on the Practice Preferences window, the existing authorizations are sorted by Effective Date in the descending order, so newer authorizations are at the top of the list and older authorizations are at the bottom. However, the authorizations continue to appear in ascending order if you have not selected the service package library. This same sort is also used on the Authorization Listing window.
Selecting the Show Active Only check box enables you to view only those authorizations where the current system date (today) falls within the Effective and Expiration Date range. This same check box option is also available on the Authorization Listing window.
When an authorization is entered for the insurance before an encounter is created, it automatically attaches to a new encounter that meets all criteria defined within the authorization.
When an authorization is entered for the insurance after an encounter is created, you can manually attach it to an existing encounter that meets all criteria defined within the authorization. This is done from the Patient Chart, Encounters tab, Insurance sub-tab, Verification section.