Authorization Overview

SmartCare will automatically attach an authorization to a service if the client has an authorization record that matches the following criteria on the service: 

  • Program 
  • Plan  
  • Date of service falls within time range listed on authorization 
  • Procedure is included in the Authorization Code Group
  • The duration of the service must match or exceed the units listed on the Authorization record for it to be attached to the service. This can be changed by a Configuration Key and is explained in the section, How to update the Configuration Key for Authorization Units.  

When entering a service, the authorization tab will stay inactive until the service is saved. Once the service is saved, the Authorization(s) tab will be enabled.  The authorization will reflect under the Attached Authorization section. 

A billing rule can be added to the plan within SmartCare to require an authorization. Please see the section titled How to setup a plan to require an authorization for details of setup.