Category Archives: Authorizations

Unique Tracking Number for Medicare PPS Claims for States Submitting Pre-Claim Review

Agencies who are or will be submitting Medicare PPS claims for Pre-claim review will need to update the Main Office Software to Version 6022 dated 09/12/16. Upon receipt of the provisional approval and Unique Tracking Number (UTN), agencies will need … Continue reading

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Navinet/Highmark Specific Items Now Available in the Authorization Request Document

Agencies will need Main Office Software Version 6010 dated 08/15/16 and Clinical Point of Care Software Version 2478 dated 08/15/16.  The Authorization Request document now has an additional tab for Insurance specific Authorization request/ justification items related to homebound status … Continue reading

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Update Related to XML File Creation For Highmark Authorization Requests Submitted Through Navinet

Updated instructions through Navinet indicate that the OASIS file to be submitted with an authorization request must not be in a zipped folder.  Navinet will accept only the xml file.  Agencies with Main Office Software Version 6002 dated 08/01/2016 will … Continue reading

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Software Changes for Submission Requirements for Authorization Requests Through Navinet for Highmark Commercial and Medicare Advantage Members

Beginning August 1, 2016 agencies requesting new and/or additional authorizations for services for Highmark commercial and Medicare Advantage members will need to upload the Patient (member) OASIS in XML format and a PDF of the patient’s Plan of Care.  To … Continue reading

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Authorization Board

As of January 31, 2014, Managed Hosting Clinical Software users will have a new screen available for tracking Authorized Visits.  The button to open the Authorization Board is available when the patient’s medical information screens are accessed.  Each authorization will … Continue reading

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Report Changes

We have added the responsible employee to the sort order for the Authorization Status Report and the Possible Billing Errors Report.

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Patient Authorizations Changes

On the authorizations screen under patient maintenance we added a “Authorizations vs Visit Only” column to the balance displays.  The existing balance column includes scheduled and unverified visits.  The new column includes only verified visits when calculating the balance.  This … Continue reading

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