Authorizations (Provider)

Service authorizations are entered in the Service Authorization form in Avatar MSO. Service authorization requests are submitted through ProviderConnect. Authorization requests are reviewed and processed in Avatar MSO.

If the service authorization is denied in Avatar MSO, the client association with the agency is deleted.

A service authorization must be filed in the Service Authorization form (Avatar MSO). The service authorization can be accessed by the agency in the 'Provider To Be Authorized' field.
CPT codes must have been created in the CPT Code Definition form (Avatar MSO).
Revenue codes must have been created in the Revenue Code Definition form (Avatar MSO).
CPT codes or revenue codes must have been associated with a provider and provider fee definition (Avatar MSO, Provider Fee Definition form).

In the Authorization Information screen click Create Request.
In the Authorization Request Information screen enter the authorization begin date.

Enter the number of days for the authorization, click Set. The authorization end date is entered.

Or, enter the authorization end date.

Click Request Authorization

The Authorization Request screen displays.

Authorization Request screen

If appropriate, select the client population.
If appropriate, enter the client's primary diagnosis code or description, click the diagnosis link in the list.
Select the client's funding source.
Select the client's benefit plan associated with the funding source.
Select the program associated with the funding source, and benefit plan.
Select an authorization group.

The CPT or revenue codes and number of units associated with the authorization group display.

Or, click Add Code to add individual procedure codes that have been associated to the client through previous service authorizations. Select the procedure code and enter the number of units.

If appropriate, enter comments associated with the authorization.
Click File Request.
The review status displays 'Not Reviewed'.

In the Authorization Request screen click an authorization number to view the Authorization Request screen.

The authorization status displays at the top of the screen.

For more information on service authorizations please refer to the Avatar MSO online documentation.