Revenue cycle

Units remaining, on the booking screen.

Dollars authorized, dollars used, visits remaining, and expiration date — live while the appointment is being scheduled. Not discovered six weeks later on a denial.

See what it costs

Covers case rates too. Per-diem and episode authorizations tracked the same way.

Live on the booking screen

Three authorizations, three different problems, all visible now.

Every active authorization draws down as sessions are scheduled and delivered. The person booking the appointment sees the same numbers the utilization reviewer sees.

Healthy

Nguyen, T. · IOP

Auth #A-88104 · Cigna

Visits used9 of 30
Days to expiry68

Renewal due

Alvarez, R. · IOP

Auth #A-88213 · Aetna

Visits used24 of 30
Days to expiry14

Blocked

Duarte, K. · Residential

Auth #A-87990 · BCBS

Days authorized21 of 21
Continued staySubmitted 09/01

To request4

Bell, A. · PHP step-downdue today
Ibarra, C. · IOP initialdue 09/16

Submitted6

Duarte, K. · residentialday 3 with reviewer
Mensah, P. · IOP extensionday 1

Approved11

Novak, J. · 12 visitsthrough 11/30
Ferreira, L. · 7 daysthrough 09/22

Expiring3

Alvarez, R. · 14 daysrenewal not started
Okafor, M. · 9 daysrenewal drafted

The economics

Care delivered outside an authorization is rarely recoverable.

An appeal can sometimes win back a denied claim. Sessions delivered after an authorization expired usually cannot be won back at all — the payer's position is that the service was never approved. That makes this the one place in the revenue cycle where prevention is the only strategy.

Who sees it

The person who can prevent the problem is the person booking the appointment.

Utilization review sees the whole queue. The front desk sees the one patient in front of them. Both need the same number, which is why it sits on the scheduling screen and not in a weekly report.

6visits left, shown at booking

Questions

Common questions.

Where can staff see how many authorized visits remain?

On the booking screen. Dollars authorized, dollars used, visits remaining and the expiration date are live while the appointment is being scheduled — the person booking sees the same numbers the utilization reviewer sees, rather than discovering the problem six weeks later on a denial.

Does it track per-diem and case-rate authorizations too?

Yes. Per-diem and episode authorizations are tracked the same way as visit-based ones — days authorized versus days used, with continued-stay requests surfaced before the authorized days run out.

Why does authorization tracking sit at scheduling instead of billing?

Because care delivered after an authorization expires is rarely recoverable — the payer’s position is that the service was never approved, so prevention is the only strategy. The person who can prevent it is the one booking the appointment, which is why the number lives on the scheduling screen and not in a weekly report.

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