View/Edit Authorization Request Page
You use the View/Edit Authorization Request page to search for an authorization request you have saved or submitted. The View/Edit Authorization Request page contains fields in the following panels:
Provider ID Fields
| Field | Description |
|---|---|
| Provider ID |
Unique identifier used by a provider of healthcare services. Automatically completed by the application. |
| Provider ID Type |
Unique code indicating the type of provider indicator. Automatically displayed by the application. |
| Submitted Authorizations | If selected, it refines the search to display only submitted authorizations. |
| Saved Authorizations | If selected, it refines the search to display only authorizations that have been saved by the provider but not submitted. |
Additional Information Fields
| Field | Description |
|---|---|
| Member ID |
Unique identifier used for a member and is assigned when the member becomes eligible to receive Medicaid benefits. |
| Service Authorization ID | Identification number associated with the service authorization (SA). |
| Header Status |
The status of the authorization. Examples: Approved, Denied, Pended, Submitted for Consideration, Voided |
| Service Code |
The revenue or procedure code for which the SA is submitted. |
| Modifier 1 - 4 |
A two-digit code attached to the procedure code to modify or clarify the description of the procedure. Up to four modifiers may be submitted on a claim for each procedure code, if applicable. |
| Begin Date | The beginning date of the service authorization. |
| End Date | The ending date of the service authorization. |
Search Results Fields
| Field | Description |
|---|---|
|
If more than one match is found, this table is displayed. To view a match, click the appropriate row. None of these fields can be edited.
After selecting the Search button, Unread Attachments button or the Unread Comments button you will see the following if new attachments or comments have been added to the Service Authorization:
|
|
| Authorization ID | Identification number associated with the service authorization (SA). |
| LI | The line number on the service authorization for this member ID, service code and modifiers combination. |
| Member Name | Member's last and first name. |
| Member ID |
Unique identifier used for a member and is assigned when the member becomes eligible to receive Medicaid benefits. |
| Service Code |
The revenue or procedure code for which the SA is submitted. |
| Modifier 1 - 4 |
A two-digit code attached to the procedure code to modify or clarify the description of the procedure. Up to four modifiers may be submitted on a claim for each procedure code, if applicable. |
| Begin Date | The beginning date of the service authorization. |
| Certification Action |
The certification status of the authorization that has been submitted or saved. It is the HIPAA value for the header status of the authorization. Examples: Certified - Partial, Not Certified, Pended, Modified, Cancelled, Contact Payer, No Action Required |
| Header Status |
The status of the authorization. Examples: Approved, Denied, Pended, Submitted for Consideration, Voided |