Prior authorizations

phineas629 wrote on Tuesday, June 23, 2015:

How does Open EMR handle prior authorizations? Is there a way to keep track for each patient?

mdsupport wrote on Tuesday, June 23, 2015:

There is no direct support for it. We have suggested adding an insurance plan for the duration of the prior auth as workaround. Like some of the other EMRs, you want an option of setting up billing plan per encounter with patient’s insurances as just defaults. That will make billers happy.

fsgl wrote on Tuesday, June 23, 2015:

OpenEMR does not have a billing module for Home Health Agencies.

The Billing Manager can only handle professional claims, not institutional claims. Prior authorization would go into Box 23 of the CMS 1500.

Per page 8 of this .pdf, Box 63 would be the UB-04 equivalent.

Terry Hill has completed the Billing Manager for institutional claims. His email is terry@lillysystems.com. I think it includes electronic billing.

He should also be able to help you keep track of the authorizations.

phineas629 wrote on Wednesday, June 24, 2015:

Thanks MD Support. Thanks fsgl. I would be using 837P for Personal Care Assistant services. But, it’s good to know that I can’t use OpenEMR for 837I as we have home care services also. I’ll contact Terry Hill.

fsgl wrote on Wednesday, June 24, 2015:

You’re welcome.

See attachment.