Overview
Most insurance plans require prior authorization before ABA services begin. Onvelas tracks authorizations, links them to appointments and claims, and alerts your team when approved units are running low.
Adding an Authorization
- Open the patient record and go to the Authorizations tab.
- Click Add Authorization.
- Select the Payer and enter the Authorization Number.
- Set the Start Date and End Date.
- Add service lines: for each CPT code authorized, enter the number of approved units.
- Click Save.
Linking Authorizations to Appointments
When scheduling, select the authorization from the dropdown in the appointment form. The system automatically deducts units from the authorization as sessions are marked complete and claims are generated.
Utilization Dashboard
The Authorization detail page shows a utilization bar for each service line:
- Green — >50% of authorized units remaining
- Amber — 25–50% remaining
- Red — <25% remaining
Authorization Alerts
Onvelas sends alerts when:
- An authorization is within 20% of its unit limit
- An authorization expires within 30 days
- A submitted claim references an authorization that has expired or is exhausted
These alerts appear in the Billing Inbox (RCW) and can be sent via email notification to the authorization coordinator.
Renewal Workflow
When an authorization nears expiration, the RCW Billing Inbox surfaces a Renew Authorization action item. Click it to open a pre-filled renewal request with the current authorization's service lines and dates for easy updating.
Tips
- Start the renewal process 30–45 days before expiration — most payers take 10–20 business days to process.
- If a claim is denied for missing auth (CARC 197), check if the auth dates were entered correctly. If the auth is valid, resubmit with the correct auth number.