Authorization and claim management is a critical component of revenue cycle management in Canvas Medical. This feature allows healthcare providers to create, link, and manage authorizations with claims to ensure proper billing and reimbursement tracking. Understanding how to effectively manage these linkages helps maintain accurate financial records and streamlines the billing process.

User's Guide

Getting Started

The Authorizations tab is located on the patient's Profile page, positioned above the patient's active coverages. This tab contains all authorization information for the patient, organized into sections:

• Active Authorizations: Current authorizations that are within their effective date range and have available visits

• Expired / Visit Limit Reached: Authorizations that have either passed their expiration date or exhausted all approved visits

  

Creating a New Authorization

1. Navigate to the patient's Profile page

2. Click the Authorizations tab above the patient's active coverages

3. Click Add to create a new authorization

4. Complete the authorization fields

   • Coverage: The insurance plan associated with the authorization

   • Authorization Number: The unique identifier provided by the insurance company

   • Start Date: When the authorization becomes effective

   • Expiration Date: When the authorization expires

   • Procedure Codes (CPT): Specific medical procedures covered by the authorization

   • ICD10 Diagnosis Codes: Medical diagnosis codes that justify the authorized services

   • Referring Provider: The healthcare provider who referred the patient

   • First Name: Referring provider's first name

   • Last Name: Referring provider's last name

   • Referring Provider NPI: National Provider Identifier for the referring provider

   • Notes: Additional comments or special instructions

   • Linked Claims: Claims that are associated with the authorization

   • Visits Approved: Total number of visits authorized by the insurance

   • Visits Left: Remaining visits available under the authorization

   • Unlimited Visits: Check this option for authorizations with no visit limits

5. Click Save Authorization

   

Removing an Authorization from a Claim

To disconnect an authorization from a claim, users can choose from two approaches:

From Patient Claim

1. Navigate to the patient's claim

2. Click the triple dot in the claim header

3. Click Edit provider details

4. Click the X on the linked authorization under the Authorization heading

5. Click Update to save changes

   

From the Authorizations Tab

1. Navigate to the patient's Profile page

2. Click the Authorizations tab above the patient's active coverages

3. Open the authorization form for the relevant authorization

4. Click the X next to the linked claim that needs to be removed

5. Click Update Authorization to save changes

   

Linking Authorizations to Claims

To link an authorization to a claim, users can choose from two approaches:

From the Patient Claim

1. Navigate to the patient claim

2. Click the triple dot in the claim header

3. Click Edit provider details

4. Select an authorization from the Authorization dropdown to link to the claim

   • Expired authorizations will be highlighted gray in the dropdown

5. The system will automatically populate the referring provider's first name, last name, and NPI fields listed on the authorization form if the fields are empty in the modal

6. Click Update to save the linked claim

   When returning to the patient profile directly after linking or unlinking claims, the authorization count will only update once the profile page is refreshed.

   

From the Authorizations Tab

1. Navigate to the patient's Profile page

2. Click the Authorizations tab above the patient's active coverages

3. Open the authorization form for the relevant authorization

4. Add the associated claim to the Linked Claim field

5. Click Update Authorization to save changes

   

Updating an Authorization

To modify authorization details:

1. Navigate to the patient's Profile page

2. Click the Authorizations tab above the patient's active coverages

3. Open the authorization form for the relevant authorization

4. Update the desired fields as needed

5. Click Update Authorization to save changes

Configuration & Set Up

Prerequisites

To access and manage authorizations, users must have Revenue Access permission. Administrators can grant this permission through staff permissions in the settings. For detailed information about user permissions, see the User Permissions article.

FAQ & Troubleshooting

Q: Why don't I see the authorization changes immediately after updating?

A: The system requires a page refresh to display updated authorization information. Always refresh the Authorization page after making changes to see the current status.

Q: What happens if I remove an authorization number from a claim?

A: Removing the authorization number from a claim will unlink the authorization from that claim. The authorization will still exist in the system but will no longer be associated with the specific claim.

Q: Will the system automatically populate provider details when I select an authorization?

A: Yes, if the first name, last name, and NPI fields are empty, selecting an authorization from the dropdown will automatically populate these fields with the correct information from the authorization record.

Q: Can I link multiple claims to a single authorization?

A: Yes, multiple claims can be linked to an authorization as long as the authorization is valid and there are remaining visits

Related Resources

• Claim Management

• Managing Staff Members

• User Permissions

Keywords: authorization management, claim linkage, billing, revenue cycle, provider details, outstanding claims, authorization number

Categories: Revenue Cycle Management, Billing, Claims Processing, Patient Management