Authorization

Doing right things

The Authorization tab is a critical financial and compliance module. It serves as the "Master Ledger" for tracking service approvals from state agencies or insurance payers, ensuring that every hour worked by staff is backed by a valid, funded authorization. Your agency usually provides services with prior authorization. This tab lets you see all the authorizations for this customer in one place. The authorizations are presented monthly, and the page allows you to navigate prior or future months.

This tab is available if your agency is a Service Provider company.

1. Date & Period Selection

At the top of the tab, you can control the timeframe of the authorizations displayed:

• Select Date Dropdown: Allows you to jump to a specific month and year (e.g., December 2025) to review historical or future allocations.

• Navigation Arrows: Quickly toggle between consecutive months using the back arrow [] and forward [] buttons.

• Calendar Picker: Use the calendar icon to select a precise date range for audit reporting.

2. Service Authorization Table

The Service Authorization data grid is the technical core of the Authorization tab. It provides a granular, line-item view of every approved service "bucket" for the client. Below is a comprehensive documentation of every field present in the grid, as well as the functional controls surrounding it.

Field Name	Description & Importance
Patient Name / DOB	Displays the client's identity (e.g., Andre Fuego Mandana Maya) and date of birth to ensure the authorization matches the specific individual.
Project Title	Links the authorization to a specific program or work scope (e.g., Andre Rios ISS 8).
Medicaid ID	The client's unique insurance identifier used for electronic claim submission.
Prior Auth	The specific authorization number (e.g., 1552058649) provided by the payer (Medicaid/MCO) which must be present on all billing claims.
Proc Code	The Healthcare Common Procedure Coding System (HCPCS) code (e.g., T2019) defining the service provided.
Proc Code Modifier	Additional codes (e.g., HI, HIUP) that provide more detail about the service (e.g., intensity level or staff credentials) to determine the exact reimbursement rate.
Diagnosis Code	The clinical ICD-10 code justifying the medical necessity of the service.
Task Start/End Date	The "Validity Window." Services provided outside of these specific dates (e.g., 12/07/2025 – 12/13/2025) will be flagged as unbillable.
Auth Units	The total number of units (e.g., 10) approved by the payer for this specific date range.
Auth Amount	The total dollar value (e.g., $100.00) assigned to this specific authorization block.
Status	Shows if the authorization is currently Active, Pending, or Expired.
Task IDs	A clickable link to the specific Tasks that have been billed against this authorization.
Task Type	Categorizes the specific activity (e.g., Community Based Support) linked to these units.
Units Used	A real-time counter showing how many units have been consumed by staff Timesheets.
Minutes Spent	Converts the "Units Used" into a total time duration for easier utilization review.
Units Remaining	The most critical field for managers; it calculates Auth Units - Units Used to show how much service can still be provided.

Grid Controls & Actions

Located at the top right of the data grid, these icons allow you to manipulate the data view:

• Column Visibility (): Allows you to hide or show specific columns (e.g., hiding "Diagnosis Code" to focus on "Units Remaining").

• Filter (): Narrow the grid view to show only specific Procedure Codes or authorizations within a certain date range.

• Density Toggle (): Adjust the row height between "Compact" and "Standard" to see more data on one screen.

• Export (): Downloads the entire grid as a CSV or Excel file for external audits or financial reconciliation.

• Save (): Saves any manual adjustments or "inline edits" made directly to the rows.

System Validation Logic

The data in this grid is used by the FieldWorker mobile app and Timesheet module to perform two critical checks:

1. Date Check: Is the current shift within the Task Start/End Date?

2. Budget Check: Are there enough Units Remaining to cover this shift?

3. Table Management Controls

Located at the top right of the table, these tools allow for advanced data handling:

• Column Visibility (Grid Icon): Customize which columns are visible in your current view.

• Filter Icon: Narrow down the list by specific Project Titles, Procedure Codes, or Date Ranges.

• Export (Upload Icon): Download the current authorization list as a CSV or Excel file for external financial reconciliation.

• Save Icon: Commit any manual adjustments made to the authorization lines.

4. Operational Impact

• Billing Prevention: The system cross-references this table when a staff member submits a Timesheet. If there are no remaining Auth Units for that period, the system will flag the shift as "Unbillable."

• Utilization Tracking: Managers can see at a glance how many units have been used versus how many remain, preventing "over-servicing" or "under-utilization" of a client's budget.

• Audit Readiness: This tab provides a clean, exportable trail of every approved service hour, which is essential for state-level audits.