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Creating Referrals or Authorizations


End users can create referrals or authorizations from the Referrals/Authorization screen.

To create a referral or authorization

  1. Navigate to the Referrals/Authorization screen.
  2. Add a record and select the request type: Authorization or Referral.
  3. Drill down on the Tracking #.
  4. Click the More Info view tab and add additional information as necessary.

    Some fields are described in the following table.

    Field
    Comments

    Last Name

    Last name of the member. The application automatically populates the First Name field.

    For more information on adding members, see Adding Eligible Members to Group Policies.

    Status

    Status of this referral or authorization.

    Requestor Last Name

    Last name of provider. The application automatically populates the Requestor First Name field.

    For more information on adding providers, see Adding Providers.

    Diagnosis Codes

    Diagnosis code for this referral or authorization.

    For more information on adding codes, see the discussion on modifying the List of Values (LOV) in Applications Administration Guide.

    Procedure Codes

    Procedure code for this referral or authorization.

    For more information on adding codes, see the discussion on modifying the List of Values (LOV) in Applications Administration Guide.

    Maximum Benefit

    The maximum dollar amount for the specified benefit.

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