Misc Billing Options (MBO) pull data from Advanced Prior Auth

juggernautsei · March 23, 2023, 5:53pm

Hi @stephenwaite,
I wanted to check with you to see if anyone has approached you about this feature/ability.
Since in the module, the CPT codes are listed with the auth. There is the possibility to apply the authorization to the billing.

Your thoughts would be appreciated.

Best!

stephenwaite · March 28, 2023, 4:53pm

hi @juggernautsei , makes sense, just need to rework some logic in the mbo form based on if the module is available I guess.

Bo_Wang · May 7, 2024, 12:09am

Hi @juggernautsei how does the Advanced Prior Auth module work? Does it automatically deduct a unit when the approved CPT code is saved to a fee sheet, or when it’s billed? Also does it have to be CPT code? Would HCPCS code work? thx… Bo

juggernautsei · May 7, 2024, 12:43am

Here is the video about the module. If you have more questions, let me know

William_Assell · May 9, 2024, 2:53am

I don’t think the video answered the question asked here. When does the countdown happen? Is it at fee sheet creation or billing of the code? Also since the cpt codes in this module is not a lookup how is it doing the countdown?

juggernautsei · May 9, 2024, 9:45am

The countdown happens here. Does this answer the question? The billing of the code is where the count is taken.

github.com

openemr/openemr/blob/6cef758e9648672979daaa9dbd588a413e4408a2/interface/modules/custom_modules/oe-module-prior-authorizations/src/Controller/AuthorizationService.php#L217

      
        
                    return $response;
                }
            
            
    public static function insuranceName($pid)
                {
                    return sqlQuery("SELECT ic.name  FROM `insurance_data` id
                        JOIN insurance_companies ic ON id.provider = ic.id
                        WHERE `pid` = ? AND type = 'primary'", [$pid]);
                }
            
            
    public static function countUsageOfAuthNumber($pid, $authnum)
                {
                    return sqlQuery("SELECT count(*) AS count FROM `form_misc_billing_options`
                                     WHERE pid = ? AND `prior_auth_number` = ?", [$pid, $authnum]);
                }
            
            
    public static function requiresAuthorization($pid)
                {
                    $sql = "SELECT `d`.`field_value` FROM `lbt_data` d
            JOIN `transactions` t ON `t`.`id` = `d`.`form_id` AND `t`.`title` = 'LBT_authorizations'
            WHERE `t`.`pid` = ? AND `d`.`field_id` = 'authorization_001'";