How to manage Authorizations in ABA Matrix (For Administrative Staff)

This guide provides step-by-step instructions on how to add approvals for clients. It explains how to select the client, navigate to the Approvals tab, add a new approval, and fill in the necessary information. It also highlights the option to set units as provisional and the importance of having available units to create new sessions. Following this guide will ensure that approvals are properly added and tracked in the system.

1. Create a New Authorization

1. From the Clients section, search for and select the client whose authorization you want to manage.

2. Go to Authorizations

From the client profile, select Authorizations. Here you can view all authorizations associated with the client.

3. Click the + button to create a new authorization.

1.1 Enter the Authorization Information

4. Complete the authorization information:

• PA Number: Enter the authorization/reference number provided by the payer.
• Procedure: Select the procedure associated with the authorization.
• Units: Enter the authorized units.
  • For a new authorization, this will typically be the total number of approved units. If you are entering an authorization in the middle of its approval period, enter the appropriate available units.
• Start Date: Enter the beginning date of the authorization period.
• End Date: Enter the expiration date of the authorization period.

5. - Set as Provisional: Use this option when the authorization has been approved or is expected, but the authorization/reference number has not yet been received.

This allows you to enter the approved units and authorization details and schedule sessions while waiting for the official authorization number. However, visits cannot be billed until the actual PA/reference number is added to the approval.

1.2 Complete the Authorization Setup

6. Once the authorization information is complete, you have two options:

1. Save Authorization: Creates the authorization with the information entered. Select this option if you do not need to configure a weekly hour limit at this time.
2. Save & Set Weekly Limit: Creates the authorization with the information entered and takes you to the Weekly Limit step, where you can configure the maximum number of hours allowed per week for that client and procedure based on the hours approved by the payer.

1.3 Set the Weekly Limit

7. If you select Save & Set Weekly Limit, ABA Matrix will calculate a suggested weekly hour limit based on the authorization dates and total authorized units entered. Review the suggested value and either:

• Accept the suggested weekly limit, if it matches the approved weekly hours, or
• Adjust the Hours and Minutes based on the weekly hours actually approved by the payer.

2. Edit an Existing Authorization

8. From the client's Authorizations section, locate the authorization you want to modify and select the option to edit it.

9. You can update authorization information such as:

• PA Number
• Units
• Dates
• Other applicable authorization settings

2.1 Update the Authorization Information

10. After making changes to an authorization, you have three options depending on what you need to do next:

1. Save the Authorization: Save the changes without updating the weekly limit.
2. Update the Weekly Limit: Save the changes and adjust the maximum weekly hours if needed.
3. Review Weekly Hours: Review the client's scheduled hours based on the configured weekly limit for each week within the authorization period.

2.2 Update the Weekly Limit, if Needed

11. Select Save & Set Weekly Limit to save the authorization changes and continue to the Weekly Limit step.

From here, you can review the system's suggested weekly limit and, if needed, enter the appropriate Hours and Minutes based on the weekly hours approved by the payer.

2.3 Review Weekly Hours, if Needed

12. After saving the authorization, you can access Weekly Review to compare the client's:

• Maximum Hours: The maximum hours allowed according to the configured weekly limit.
• Scheduled Hours: The total hours currently scheduled for the client and procedure.
• Difference: The difference between the maximum allowed hours and the scheduled hours for each week within the authorization period.

3. Edit the Weekly Limit

13. You can also access the Weekly Limit directly from an existing authorization without changing the rest of the authorization information.

• Open the Weekly Limit option for the applicable authorization and procedure.

14. ABA Matrix will calculate a suggested weekly limit based on the authorization dates and total authorized units. Review the suggested value and, if needed, enter the appropriate Hours and Minutes based on the weekly hours approved by the payer.

3.1 Update the Weekly Limit

15. After entering the weekly limit, you have two options:

1. Apply Weekly Limit: Applies the weekly limit and completes the update.
2. Apply & Review Weekly Hours: Applies the weekly limit and takes you directly to Weekly Review, where you can compare the configured weekly limit with the client's scheduled hours.

3.2 Review Weekly Hours

16. After saving the authorization, you can access Weekly Review to compare the client’s Maximum Hours, Scheduled Hours, and Difference for each week within the authorization period.

4. Review Weekly Hours

17. You can access Weekly Review directly from an existing authorization when you want to review weekly utilization without changing the authorization or weekly limit.

18. Weekly Review displays the authorization period week by week. For each week, ABA Matrix displays:

• Week (Start Date / End Date): The date range for each week included within the authorization period.
• Maximum Hours: The maximum hours allowed for that week based on the configured weekly limit.
• Scheduled Hours: The total time currently scheduled for that client and procedure during the week.
• Difference: The remaining hours available or the amount by which the scheduled hours exceed the configured weekly limit.

This allows you to compare the client's scheduled hours with the maximum weekly hours configured for the procedure and quickly identify weeks that may exceed the limit.

19. You can also download an Excel report containing the weekly utilization information. The report includes the weekly information for the authorization period, allowing you to save, share, or further review the Maximum Hours, Scheduled Hours, and Difference for each week.