Insurance companies may provide a set number of authorized services that they’ll cover, or an end date by which those services should occur for a specific client by assigning a prior authorization number. The assigned prior authorization number needs to be included on claims in order for the payer to cover the authorized services. 

SimplePractice's Authorization tracking feature allows for the prior authorization number from a client’s profile to be automatically applied to their insurance claims.

In this guide, we’ll cover:

• Adding a prior authorization number to a client's profile
• Recording multiple authorization numbers
• Reminders for expiring authorizations
• Auto-populating authorization numbers on insurance claims
• Tracking the number of sessions remaining

Adding a prior authorization number to a client's profile

To add a prior authorization number to a client’s profile:

• Navigate to the client’s Overview page
• Click Edit
• Select the Billing and Insurance tab
• Scroll down to Authorization tracking 
• Click + Authorization number

• Enter the prior authorization number, the number of uses, and the dates through which the authorization is valid
• You can also choose to be reminded of the expiration of the prior authorization, and select whether the authorization is active

• Click Save Client

Note: You can also use this feature to track how many authorized appointments a client has left, even if the client doesn't have an authorization number. To do this, enter a number (such as "1") into the Prior authorization number field and continue completing the fields.

Recording multiple authorization numbers

You can record multiple authorization numbers in a client profile for current use and for historical purposes. However, only one authorization number can be Active in the profile. To change the authorization number that’s active, select Active.

The Active authorization number is the one that will populate onto insurance claims and display on the client's Overview page in their Insurance Info section.

Reminders for expiring authorizations

Each authorization number will give you the option to receive a reminder 1 month before the authorization expires. You’ll receive this reminder in the Reminders section of your account.

Note: At this time, the expiration reminder can only be sent 1 month before the authorization number expires, as opposed to sending a reminder with the number of sessions remaining.

Auto-populating authorization numbers on insurance claims

A client’s Active authorization number will automatically populate onto insurance claims in Box 23:

Note: Prior authorization numbers are payer-specific. If the client has coverage with more than one insurance company, the authorization number will automatically populate for both the primary and secondary claim. If you’re filing a secondary claim, you’ll need to manually edit Box 23 on the secondary claim form. Additionally, if you are filing to a payer that doesn't require an authorization, you’ll need to remove the authorization number before submitting the claim to the payer.

Tracking the number of sessions remaining

There are three ways to track the number of authorized sessions remaining for a client:

• The first option is to create a chart note
  • A chart note can be pinned to the top of a client's Overview page by setting the date to a time far in the future

• You can also record the amount of authorized sessions remaining in a client's Progress Note or Psychotherapy Note

• Your third option is to update the amount of authorized sessions remaining in the Client Notes section of a Client Info page