Unauthorized Service Listing

This process will review all services entered in the system to make sure there is a service authorization/available units. Any service without an authorization will be listed on this report.

If all billable services are authorized and have enough units to bill, the report will be blank.

The Unauthorized Service Listing is always the first step to the billing process.  

REQUIRED STEP: This step is required to mark services to pull into the EDI billing file.  If you do not run this report, your EDI edit list and billing file will not include any billing.

Unauthorized Service Listing

NAVIGATION: BILLING/AR menu > Billing Preparation > Unauthorized Service Listing

  1. On the left side of the screen, select the UNAUTHORIZED SERVICE LISTING icon.
  2. SERVICE DATE RANGE: enter or select the begin and end date. Remember, be sure to use the same date range throughout the entire billing process.
  3. FACILITY: leave blank for all or select a specific facility
  4. PROGRAM: leave blank for all or select a specific program
  5. CASE NUMBER: leave blank for all consumers or select a specific consumer 
  6. SERVICE: leave blank for all or select a specific service code
  7. PAYOR: select PROMISe
  8. UPDATE SERVICE AUTHORIZATION NUMBER: check this box to update the number of available units on the consumer's service authorization
  9. Place a check mark in the NOTIFY box and click the PROCESS button.
    1. When the report is ready to review, a prompt will appear that says the report is complete. 
    2. Click YES to open the report in a new window.
    3. If you do not click notify, you will need to access the report from your dashboard and it will open in the same window.
  10. If you want to create an Excel file, check the EXPORT TO FILE box before you process the report.
    1. The report will display on the screen and the file will be available on your dashboard so you can download/save it to your computer.

Review Report

  1. Review the report that is generated.
  2. If the report is blank, all services in the billing time frame have an authorization for service.
  3. If the report lists any consumers/service provided, you'll need to research the issue and correct before submitting the billing file.
  4. Review:
    1. Client Master Service Authorizations
    2. Facility Master Setup
    3. Service Detail Report
      1. Run the report for the entire time frame of the service authorizations - 7/1 to 6/30
      2. Review the overall total number of units in the system for the service code.  
      3. Compare the total number of units on this report to the number of units authorized.  
      4. Typically, the amount on the report is more than the authorized services - which is why they are appearing on the unauthorized report.
  5. Once you have corrected the issue, re-run the Unauthorized Service Listing. 

VIDEO: Unauthorized Service Listing

8/2024

NEED MORE HELP?  Submit a ticket to the Help Desk or call (814) 535-7810 or (800) 889-3388