Insurance Authorization Tracking

midder wrote on Thursday, October 13, 2011:

Hello

I am running 4.0. I will likely upgrade to 4.1 this weekend.

I am supporting a mental health clinic. There is a need to store and track insurance authorizations in the system. A patient’s insurance company may authorize them for, say, 5 visits with a certain therapist. We need to be able to enter this authorization in the system, and then we need the ability to track these authorizations, when they are used, etc. We also need to be able to report on this stuff.

Does anyone have any suggestions for me on how we might be able to implement this type of functionality?

Thank you.
Brian

midder wrote on Friday, October 14, 2011:

Hello

Maybe I am asking the wrong question.

How do you deal with pre-authorizations of any kind in OpenEMR? IE you need an authorization from the insurance company to perform a specific procedure. How is that tracked in OpenEMR?

Any ideas would be greatly appreciated.

Best.
Brian

zhhealthcare wrote on Friday, October 14, 2011:

Brian
This is not being handled withing OpenEMR at this point. 

Thanks
Shameem

midder wrote on Friday, October 14, 2011:

Thank you Shameem

It surprises me that this is not something handled within OpenEMR, as it seems like a fairly common occurrence in all but general practice. Hopefully this can be analyzed for future inclusion. It does seem that it would be fairly complicated to work into the current UI.

I will try and come up with a workaround in the meantime, however cumbersome.

Thank you again for your reply.
Brian

midder wrote on Thursday, October 27, 2011:

The more I think about how I would try and work around this issue, the more it surprises me that this is not a function of the system, or at least not something that is discussed more often. This has got to be a fairly common scenario. Do people not have a need to track that certain procedures are authorized?

midder wrote on Thursday, October 27, 2011:

We ended up implementing this in the disclosure section. I added a disclosure type called “Authorization” and we are tracking them there. I’d love to hear how others are handling this issue.