Clip and Copy: Keeping track of preauthorizations

Insurance paperwork for tests and other services needn't get lost in the shuffle.

If you sometimes don't get paid for services because you neglected to follow the precertification rules that many plans impose, try using the form below. It comes from Billing & Collecting Tools for the Physician Office, a practice management book published by Practice Support Resources in Independence, MO.

"This form is designed to capture the information needed to expedite authorization from health plans. It also allows for documentation of preauthorization requests and facilitates insurance claims processing," says Mike Martin, president of Practice Support Resources. (To order PSR booklets, call 800-967-7790, or go to www.practicesupport.com.)

Insurance companies' prior authorization requirements change. Health Net of Arizona, for example, abolished most prior authorization rules in 2000, then reinstated them the following year. So if your patient needs tests, specialty care, or other services, be sure to check whether preauthorization is necessary.

Practice management consultants recommend that you keep two copies of pending preauthorizations—one in the patient's medical record and another in a file at the front desk.

To view the form in Word you must have Word 2000 or better. If you don't have this program you can download the free Microsoft Word 97/2000 Viewer. (You cannot edit an open document in Word Viewer. However, you can copy text to the Clipboard to paste it in other applications).

Other forms and patient handouts are available in the Clip and Copy section of our Web site at www.memag.com .

Gail Weiss. Clip and Copy: Keeping track of preauthorizations.

Medical Economics

Aug. 6, 2004;81:66.