EAP Authorization Workflow

1.     Add EAP insurance packages: (will usually be done by PSC however, if scheduling with front desk follow this  process): 

            a.      Scroll to Insurance section in Quickview > Select "Add case policy"

            b.      Search for "EAP" and select the correct insurance package for the EAP

                        

      i.      Note: If a patient is unsure of their EAP insurance provider enter self pay into primary insurance instead and  inform them they will need to be self pay until information can be provided.

2.      Add Authorization to insurance package:

            a.      Scroll to insurance policy and select "Add incoming authorization"

            

            b.      Select "Pre-Cert" As the type

            c.      Enter the authorization # into the “Insurance authorization” field. 

            d.      Enter the Start date and End date of the EAP in the “Effective date” field.

            e.       Add the # of visits approved and remaining 

            f.        In “Additional information” enter:

                        i.  EAP contact number

                       ii. The name of the provider that the patient obtained the authorization for

                      iii.  Any CPT codes that are to be billed. Ensure to input the CPT codes in the chart alert as well and inform your provider of the allowed codes.

                

            g.       Under “Associated appointments” add the appointments to the EAP Auth. ONLY add therapy appointments associated and only the number of visits that are authorized. 

            h.         Select “Save”

            

            NOTE: Do NOT select any associate appointments at this time. 

   

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