Authorizations: WebPT EMR and RevFlow

Let’s review how authorizations work with the WebPT EMR and RevFlow. In this article, we’ll address the most common questions and scenarios encountered. 

How do I add an authorization in the WebPT EMR?

Authorizations are added to the patient’s case in the WebPT EMR, either during the initial case creation or later by editing the case. Click here to learn how to add an authorization.

Important: You must include the Authorization #. If you do not have the auth number, you can enter 0000 to bypass the system requirements and allow the authorization to flow into RevFlow. Otherwise, the authorization will not flow into RevFlow and all related claims will be placed on the Claim Delay report.

When do authorizations flow into RevFlow?

There are a few rules which guide authorization integration into RevFlow from the WebPT EMR once the authorization has been added to the patient’s case and the patient has been saved.

  • The authorization flows into RevFlow as soon as you save the patient as long as the date you add the authorization is within the authorization effective dates. 
    • For example, if the auth effective dates are between 12/1 and 12/31, adding the auth on 12/1 works, 11/30 or 1/1 would not. 
  • Otherwise, the authorization will flow into RevFlow if a date of service within the authorization’s effective date range is finalized.
    • For example, if the auth effective dates are between 12/1 and 12/31, and a date of service for 12/6 is finalized, the authorization will integrate and attach to all the dates of service within the effective date range. 

What happens if I add an authorization after a note has been finalized?

In situations where one or more notes were finalized before the authorization was added to the patient’s case, the authorization will automatically attach to all relevant charges starting with the oldest date of service. As previously mentioned, the authorization will only be attached to dates of service that fall within the authorization’s effective date range. Any dates of service being held on Claim Delay will be automatically released once the authorization is attached.

What rules do authorizations follow once in RevFlow? 

The following rules dictate how authorizations impact charges and RevFlow once the authorization has imported into RevFlow.

  • If the authorization is present on the patient’s case and is valid for the Date of Service, it automatically attaches to the charges when billed.
  • If an authorization is not added to the patient case and the insurance is not set up to require authorizations, then the claim will bill without an authorization attached.
  • If an authorization is not added to the patient case and the insurance is set up to require authorizations, the charges automatically appear on the Delayed Claims report. These claims will not bill until the authorization is added.

What happens when an authorization expires or runs out of visits?

When a note is finalized after the authorization expires or runs out of visits, the date of service is automatically placed on Claim Delay for No Authorization.

When you receive the new authorization, there are a few things to remember when updating the patient’s case: 

  • Never add a new authorization that has the same authorization number as a previous authorization on the patient’s case. If you need to extend the existing authorization, please edit the original authorization and update the Effective End date or the visit count.
  • Never add a new authorization where the Effective Start date overlaps with the Effective End date of the previous authorization. The system will not know which authorization should be followed and this will create problems with authorization attachment and reporting. We recommend updating the previous authorization’s Effective End date to be the day prior to the Effective Start date of the new auth.

Once the authorization is added to the patient’s case, the authorization will automatically be added to all relevant claims on the Delayed Claims list, starting with the oldest date of service. Claims will automatically be scrubbed to bill that evening. Remember, if the DOS does not fall within the effective date range, the authorization will not be added and the claim will stay on Delayed Claims.

How do I add a backdated authorization to a past date of service?

If the date range of the authorization has passed (i.e. Today is 2/11/2020, and the authorization effective range is 1/1/20-1/31/2020) and there are not additional dates of service that need to be finalized within the effective date range, complete the following actions depending on your service level.

RevServe

Once you've obtained the authorization, add it to the patient's chart in the WebPT EMR. Then, email updates@webpt.com so they can attach the auth to those charges.

RevEquip

We recommend adding the authorization into the WebPT EMR and ask the therapist to addend a note within the Authorization effective dates. This ensures the authorization flows into RevFlow and will automatically attach to all dates of service within the effective date range.

If an addendum cannot be completed, you can manually add the authorization in Billing and choose whether to automatically apply to all dates of service or manually attach it to the correct date of service.

  1. Navigate to the patient’s account and click Cases.
  2. Double-click on the Case Name to open the details.
  3. Click the Edit button at the bottom of the screen.
  4. Open the Primary Insurance tab and click Add New Pre-authorization.
  5. Complete the authorization information and click Save in the bottom right.
  6. To automatically attach the authorization to all relevant dates of service, click Ok. If you click No, you can manually update the authorization for specific dates of service.
  7. To manually add the authorization, navigate to Error Corrections, and follow these instructions

What happens if I need to addend a date of service that has an authorization?

If you finalized documentation on the wrong patient, addend the note and no charge the visit. Email revflowsupport@webpt.com and request those charges be removed. The authorization count will be inaccurate until those charges are inactivated in RevFlow.

If you addended the note to update the number of units or CPT codes billed, no additional action is needed on your part. The system will automatically handle these types of changes.

Where can I see authorizations in RevFlow?

Once the authorization is added to the patient’s case in the WebPT EMR, you’ll be able to view them under the Primary Insurance section of the patient’s case.

To view the authorization:

  1. Navigate to the patient’s account and click Cases.
  2. Double-click on the Case Name to open the details.
  3. Click on the Primary Insurance tab.
  4. You can view the authorization details in the Pre-Authorizations section.

When is the authorization count updated?

Once the authorization is attached to the charge in RevFlow, the visits used count will be updated. The system does not wait until the charge is billed to update the used visit count. 

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