Manage All Pre-Authorizations – CareStack: User Resource Center

With a pre-authorization, you submit the treatment codes to the carrier and ask what they will pay instead of completing the treatment and then hoping they pay. CareStack helps you with pre-authorizations by prompting or creating them for you when those details are part of your insurance plan. In the Pre-Authorization section of the Insurance Plan Details, you can define the codes that must be pre-authorized by the carrier.

Note: An Authorization is not a guarantee of payment. Follow your practice's operating guidelines for the processing of your pre-authorizations.

Let's take a look at how to create and manage them inside CareStack. To view separate workflows for managing the pre-authorization of a single patient click here.

Topics Covered

Manage All Pre-Authorizations
Submission and Other Actions on a Pre-Auth Form

Manage All Pre-Authorizations

Watch this tutorial for a thorough walkthrough.

To manage all pre-authorizations of all patients, perform the following steps.

Navigate to the System Menu > select Pre-Authorizations.

Here you can sort the view of pre-authorizations by the following criteria. Select the respective tabs according to your needs.
- Pending Submission: Select this tab to view pre-authorizations that have not been sent to insurance yet.
- Rejected: Select this tab to view pre-authorizations that were rejected from the clearinghouse, for a multitude of reasons.
- Pending Response: Select this tab to view pre-authorizations that have not received a response from the carrier yet (or received and not entered yet).
- All Pre-Auths (Authorizations): Select this tab to view all pre-authorizations in one place, regardless of their status.
  - Select 'Show pending Pre-Authorization(s) only' to view only pre-authorizations that are pending submissions.

Filter Pre-Authorizations

You can track the required pre-authorizations using the filters from the grid. The available filters are given below.

Pre-Auth. ID (Pre-Authorization ID)
Pre-Auth No. (Pre-Authorization No.)
Patient
Tx. Provider (Treatment Provider)
Location
Carrier
Plan
Mode
Insurance Type
Submitted Date
Pre-Auth Flag (Pre-Authorization Flag)
Status

Submit Pre-Authorizations

You can submit a pre-authorization in two ways; electronic transmission or paper-based pre-authorization submission.

To submit a pre-authorization:

Select the required pre-authorization(s).
Click on three-dotted Menu.
Click Transmit selected Electronic Pre-Authorization(s) or Print & Submit selected Paper Pre-Authorizations(s) whichever is needed.

Print or Delete Pre-Authorizations

To print or delete a pre-authorization from the grid:

Select the required pre-auths.
Click Print or Delete as needed.

Note: A completed Pre-Authorization cannot be deleted, but you can void it instead. Only Pre-authorizations in the Draft, Ready to Send, and Document Pending statuses can be deleted.

Change Status of Pre-Authorization

To change the pre-authorization status from the Status column,

Select the All Pre-Auths tab.
Select the relevant Status for the intended pre-authorization from the Status grid.
- For example, you can Resubmit a Pending pre-authorization.

It is essential to track pre-authorizations by its status type. The types of statuses are listed below for your reference:

Completed
Draft
Pending
Ready to Send
Rejected
Document Pending
Void
Ready to Send (R)
Pending (R)
Acknowledged (Payor)
Finalized (Payor)

Void a Pre-Authorization

A completed Pre-Authorization cannot be deleted, but you can void it instead. Only Pre-authorizations in the Draft, Ready to Send, and Document Pending statuses can be deleted.

Let's walk you through how to get this done.

Select the All Pre-Auths tab.
Select Void Status for the intended pre-authorization from the drop-down.

Enter Carrier Pre-Auth Control No and Remarks.
Click Ok.

Note: This Control No. and Remarks will be applied to all the selected pre-auths.

A warning modal will appear asking, 'Do you want to generate a new Pre-Authorization from the void authorization?'
Select 'Yes' or 'No' as suited to your requirements.

A toast notification will appear on the top right stating, 'Pre-Authorization Voided Successfully.'

To Bulk Void Pre-Auth,

Select the pre-auths to void.
Click on the three dot menu on the top right.
Select Bulk Void.

Note: Bulk Void will be disabled if the selected pre-auths are in Draft status.

Enter Carrier Pre-Auth Control No and Remarks.
Click Ok.

A toast notification will appear on the top right stating, 'Pre-Authorization Voided Successfully.'

Submission and Other Actions on a Pre-Auth Form

Watch this video for a quick overview.

Let’s explore how to submit and edit Pre-Auth forms in CareStack.

To get started:

Navigate to the System Menu > select Pre-Authorizations.
You can find the pending submission form under Pending Submission or the All Pre-Auths tab.

Click on the intended pre-authorization that needs to be submitted.

If there are any remarks, they will be displayed as a note on the top of the form, which you need to rectify.

You can choose the Pre-Authorization Channel from the form to be Electronic or Paper Based.
To attach electronic attachments, select Yes for the E-Attachment Required option. This will allow you to add e-attachments via CS Attachments or NEA Fast Attach.
After making any changes, click Save.
To directly submit the pre-auth form to the clearing house, click Save & Submit.
The status of the pre-auth will be Ready to send.