Add a New Authorization

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Some insurance payers require clients to receive Authorization prior to a Service or Services. To use the Authorization Tracker in NSS, agencies must mark the client insurance as requiring Prior Authorization. Agencies can do this from the Billing Engine or, if they do not have a Billing Engine, the Face Sheet. 

Mark Client Insurance as Requiring Prior Authorization (Billing Engine)

1. Within the Billing Engine, click the Client Insurance button.
2. Enter a Case No., or click the Search buttonto search for the client.
3. Select the insurance you want to edit and click the Edit Insurance button. Or, double-click the insurance to open the Client Insurance Form window.
4. Click Page 2 if you are using the Virtual Front Office (VFO) or Page 3 within the Virtual Private Office (VPO).

1. Click the Edit button.
2. Select the Prior Authorization Required? checkbox.
3. Click the Save button.

Mark Client Insurance as Requiring Prior Authorization (No Billing Engine)

If your agency does not use the Billing Engine, you can mark Client Insurances as requiring Prior Authorizations from the client's Face Sheet.

1. Within NSS, navigate to the Face Sheet.
2. Search for the client if the client is not already displayed.
3. Click Edit.
4. Scroll down to the Client Insurance Plan section.
5. Under the Covered Benefits section of the Insurance you want to mark as requiring prior Authorization, select one of the following options depending on the client's insurance:
   • Pre-authorization required for Mental health benefits?
   • Psych Testing?
   • Substance Abuse Benefits?
6. Click Update.

Add a New Authorization for a Client

Once an insurance is marked as requiring Prior Authorization for a client, the Authorization Tracker will display within NSS. The Authorization Tracker can be displayed on any kind of Note, Face Sheet, or within the Individualized Treatment Plan (ITP) Wizard.

1. Navigate to a Note, Face Sheet, or ITP from the Main Menu.
2. Search for the client if the client is not already displayed.
3. Click Add a New Authorization.

1. Complete the following fields as necessary for the Authorization:

• Insurance: Select the insurance that the authorization is for.
• Auth Units: Enter the units of services approved by the insurance, if applicable. 
• Auth Visit:  Enter the number of visits approved by the insurance, if applicable. Visits are distinct days of service (e.g.: If the client is authorized for 5 visits, that means within the 5 day time frame they are authorized for as many services as needed).
• Effective Date: Enter the Authorization start date.
• Expiration Date: Enter the Authorization end date.
• Procedure: Select the procedure authorized by the insurance payer. If multiple procedures are authorized, you must select the group option for those codes from the drop-down. 

• Authorization Number: Enter the number provided by the payer.
• (Optional) Notes: Enter any notes as necessary.

1. Click Save Auth. The Authorization Tracker now displays the authorization information for the client on Notes, Face Sheet, and within the ITP.

Send Authorization Information to Billing Engine

1. To send the Authorization details to the Billing Engine, click the plus sign to expand the Authorization.

1. Click CONFIRM TO Billing.

1. Once you've confirmed the Authorization information to the Billing Engine, a "C" is displayed next to the Auth # within the Authorization Tracker. The information is displayed in the Caps section of the Client Insurance Details List in the Billing Engine.