Authorizations Search

The Authorizations Search page displays the results of an (advanced or quick) search of the most recent versions of authorizations. Once executed, this page shows a list (display only) of the authorizations that meet the search criteria. The page provides direct access (using a deep-link) to the Authorizations page so the user can access the details of the authorization (depending on the authorization status and user access restrictions).

A new Authorizations Search page tab will open if the user either executes a query using the quick search function in the Authorizations regional area or clicks on the advanced search button in the regional area (described in Authorizations Menu). The retrieval and display of data in this page is subject to restrictions described in the implementation guide for User Access.

The advanced search functionality is located in the upper part of the Authorizations Search page local area. The advanced search offers the possibility to search on the fields on the authorization as mentioned below;

Criterion Description

Code

The unique identifying code of an authorization

Status

The status of the authorization. Possible values are

  1. Entry

  2. In Process

  3. Pended

  4. Changed

  5. Denied and

  6. Approved

Brand

The brand to which the authorization belongs to. Drop-down list with all available brands

Type

  1. Authorization

  2. Notification

  3. Referral

Form

The possible authorization forms (categories) of incoming authorizations to choose from

Requested by Provider

The organization or provider requesting the authorization for services

Requested by Relation

The relation requesting the authorization for services

Requested for

The type and code of the insurable entity for which the authorization is requested (two search fields)

Requester Reference

The number or code used by the requester to identify the authorization

Service Provider

The provider delivering the specific services to the serviced person or object

Provider Group Scope

The scope with respect to provider groups (In, Out or Either)

Service Specialty

The specialty for which the authorization is requested

Location Provider

The location at which the services will be provided

Start Date

The start date of validity of the authorization

End Date

The end date of validity of the authorization

Requested Renewal Reference

The requested renewal reference of the authorization limit. Possible values are

  1. Calendar Year

  2. First Claim

  3. First Claim Irregular

Requested Renewal Period

The requested renewal period (length and unit of measure) of the authorization limit (two search fields)

Renewal Reference

The renewal reference of the authorization limit. Possible values are

  1. Calendar Year

  2. First Claim

Renewal Period

The renewal period (length and unit of measure) of the authorization limit (two search fields)

Currency

The currency of the authorization

Requested Amount

The total amount for which services are requested

Requested Units

The number of services for which the authorization is requested

Requested Service Days

The number of service days for which the authorization is requested

Authorized Amount

The total amount for which authorization is approved.

Authorized Units

The number of units for which the authorization is approved

Authorized Service Days

The number of days for which the authorization is approved

Override Cover Limits?

Should the adjudication cover stop limits be overridden if this authorization is applied in OHI Claims Adjudication and Pricing Adjudication?

Service Type

The service type for which the authorization is intended

Procedure

The procedure for which the authorization is intended (only looks at the procedures specified on authorization lines)

Procedure Group

The procedure group for which the authorization is intended (only looks at the procedure groups specified on authorization lines)

Basket

The basket for which the authorization is intended (only looks at the authorization baskets)

Diagnosis

The diagnosis for which the authorization is intended

Remarks

Additional information for internal use

Access Group

The data access group that controls the access to the authorization in the UI pages

Dynamic Fields

Dynamic fields configured for authorizations

Note that it is not allowed to search without criteria or use wildcards in the first position.

Search Results

Authorization Search

Once the search is executed and processed, the search results will display in the lower section of the page. The header of this section shows the number of returned search results. Note that the search only applies to the most recent versions of authorizations, meaning that older versions of authorizations are never returned in the search results. The following (read-only) fields are displayed:

Column Description

Code

The code of the authorization

Type

The type of the authorization 1) Authorization 2) Notification 3) Referral

Form

The possible forms (categories) of incoming authorizations

Status

The status of the authorization

Description.

This field displays a combination of the following information

  • For {insurable entity type singular display name + if Person: formatted relation name if Object: insurable object description}

  • Service Provider

  • Location Provider

  • Start Date

  • Unfinalize reason

If the authorization has stopped processing due to a technical error, a 'Processing Error' link appears as well in this column. Clicking it opens the 'View Technical Errors' page in the context of this authorization, where the user can reprocess the technical error.

The search results are ordered by the authorization code. All results are shown in a single table. The user can go through the search results by using the (search result) table scrollbar. When a search yields more than the maximum number of results that can be displayed in the page, the user is warned by a message in the header of the section.