Service Billing - Authorization Check Breakout

Is there a T1041 authorization in place?

Yes ✅

 

No ❎

 
 

Is there an authorization service level component in place for service delivered?

Yes ✅

 

No ❎

 
 

Set as PPS Billing

 

Determination needs to happen for which authorization to submit.  System will fail activity unit that point in time.

 

Is there a pending T1041 authorization place?

Yes ✅

 

No ❎

 
 

Is there a pending authorization service level component in place for service delivered?

Yes ✅

 

No ❎

 
 

Pending authorization approved?

Yes

 

No

 
 

Set as PPS Billing

 

Determination needs to happen for which authorization to submit.  System will fail activity unit that point in time.

 

Is there a Fee for Service authorization in place?

Yes ✅

 

No ❎

 
 

Set as Fee for Service Billing

 

Is there a pending Fee for Service authorization in place?

Yes

 

No

 
 

Pending authorization approved?

Yes

 

No

 
 

Set as Fee for Service Billing

 

Determination needs to happen for which authorization to submit.  System will fail activity unit that point in time. 

 

 

Determination needs to happen for which authorization to submit.  System will fail activity unit that point in time.

 

Is there a Fee for Service authorization in place?

Yes ✅

 

No ❎

 
 

Set as Fee for Service Billing.

 

Is there a pending Fee for Service authorization in place?

Yes ✅

 

No ❎

 
 

Pending authorization approved?

Yes ✅

 

No

 
 

Set as Fee for Service Billing.

 

Determination needs to happen for which authorization to submit.  System will fail activity unit that point in time.

 

Determination needs to happen for which authorization to submit.  System will fail activity unit that point in time.

 

Written By Amanda Griffin (Super Administrator)

Updated at January 28th, 2025


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