Authorization Management - Tasks athenahealth Processes Report

athenaCollector + athenaClinicals

athenaOne for Hospitals & Health Systems

The Authorization Management - Tasks athenahealth Processes report lists all authorization management tasks that athenahealth has processed and is processing for your organization if you use the athenaOne Authorization Management add-on service. For more information about athenaOne Authorization Management, see Authorization Tracker.

Note: Authorization tasks that are closed by the rules engine are not included in this report.

Features and workflows

Note: The CURRENTSTATUS column indicates the status of an authorization task. Tasks with a status of IN PROGRESS are still being processed by athenahealth.

Authorization tasks that are closed by the rules engine are not included in this report. The rules engine closes authorization tasks when it determines that the associated order does not require authorization. If the rules engine cannot confidently automate a "not required" determination for an authorization task, the authorization management service contacts the payer directly.

Note: If you have any questions about your implementation of athenaOne Authorization Management, please contact your Customer Success Manager.

athenaOne Authorization Management service

athenaOne^® Authorization Management is an optional add-on service for organizations that use both the athenaCollector and athenaClinicals services (the service is included in athenaOne for Hospitals & Health Systems).

With athenaOne Authorization Management, athenahealth completes authorization work for you, including:

Obtaining precertification to perform future services
Logging referrals with payers, based on payer requirements
Following up with payers to continually check on the status of the authorization

The Authorization Tracker displays the progress of your authorization tasks and each interaction with payers. athenahealth manages requests for additional documentation and assigns tasks to you only when absolutely necessary or when a conversation is needed.

Orders that require authorization include an embedded authorization status window at the top of the order document.

You can click View details to open the detailed authorization or referral status window. athenaOne guides you through the steps you need to take to resolve any issues with authorization tasks (see Guided workflow for authorization and referral management).

Note: athenaOne does not create authorizations for orders that were created before the go-live date for athenaOne Authorization Management.

Authorization statuses

Authorization tasks are assigned a status. Following is a list of authorization statuses with examples of when these statuses apply (not all reasons are shown).

Needs practice attention: Waiting to start — athenahealth has not started authorization work on this task. The authorization task is on hold and requires action on your part, for example, if a task is missing a clinical provider, requested date of service, requested service length, or requested procedure codes, or if the order has not been signed.
Needs practice attention: Action required — athenahealth started authorization work on this task, but you need to take additional actions, for example, obtaining a referral from the PCP or adding an insurance plan. The authorization task is on hold and requires action on your part.
Needs practice attention: Denied — The authorization task is denied and requires your review.
In progress with athenahealth — athenahealth is working on this authorization task. No action is needed from you at this time.
Approved — The payer approved the authorization task and the patient is ready to have the procedure.
Not required — Authorization (precertification or referral) is not required as determined by the payer guidelines established for this procedure, diagnosis, and service length.
Not supported by athenahealth — The provider, insurance, or facility is ineligible for athenaOne Authorization Management, or your organization excluded the provider, insurance, or facility from Authorization Management.
Canceled — The procedure was canceled and no further action is required.
Note: Tasks with the status "Needs practice attention: Action required" that are 60 days past their date of service are automatically cancelled.
Denial reviewed by practice — The authorization for the procedure was denied; your practice has reviewed the denial. The authorization is still marked as Not complete so that you can take action on the denial.

Field Reference

Run Report: Authorization Management - Tasks athenahealth Processes Report
From date - To date	Enter or select the date range for the report. All authorization tasks with a date of service within the specified date range are included in the report. Note: If your fiscal year does not align with the calendar year, you can select date ranges for the fiscal year or the calendar year, for example, Fiscal Quarter-to-Date, Previous Fiscal Year, Previous Calendar Quarter, or Calendar Year thru Previous Month.
Report Format	Select the format for your report results. HTML table — Display the report results on your screen. Text (tab-delimited) — Export the report results to a .csv file in tab-delimited format. Text (comma-delimited) — Export the report results to a .csv file in comma-delimited format.
Report Options	Select other options for your report results. Suppress Column Headings — Select this option to remove column headings from the report results. Suppress Report Name — Select this option to remove the report name from the report results. Show Filter Criteria — Select this option to include your selected filter criteria in the report results. Run Offline (will appear in your Report Inbox tomorrow morning) — Select this option for very long reports. Reports that are run offline appear in your Report Inbox the morning after the request.
Column Headings
ORDERID	Unique document ID of the order. You can click the linked ID number to display the order document.
AUTHTASKID	Unique document ID of the authorization task associated with the order. You can click the linked ID number to display the authorization task. An authorization task is the electronic document shared between athenahealth and your organization and is used to record the information required for the authorization work.
AUTHTASKCREATED	Date that the authorization task was created.
DATEOFSERVICE	Date of service for the test, procedure, surgery, or consult documented in the authorization task.
ORDERINGPROVIDER	Provider that ordered the test, procedure, surgery, or consult documented in the authorization task.
DEPARTMENT	Department in which the order that triggered the authorization task was created.
ORDER_GROUP	Order type group of the order documented in the authorization task: CONSULT, IMAGING, PROCEDURE, or SURGERY. Note: The order type group in the report corresponds to the selections available from the Order type filter field on the Authorization Tracker page.
ORDER_NAME	Name of the order type documented in the authorization task.
INSURANCE	Primary insurance company to which the authorization or precertification request was submitted.
COMPLETED_DATE	For authorization tasks that are not in progress, date that the authorization was approved, cancelled, or deemed not required. Note: For descriptions of task statuses, see Authorization statuses.
CURRENTSTATUS	Current status of the authorization task, for example, APPROVED, IN PROGRESS, NOT REQUIRED, or CANCELLED. Note: For descriptions of task statuses, see Authorization statuses.
SENDERHOLDS	Number of times that the authorization task was set to the status "Needs practice attention: Action required."
PEER_TO_PEER_YN	Indicates whether the task was set to the status "Needs practice attention: Action required" because the authorization required a peer-to-peer review with the insurance company (Y = Yes; N = No).
AUTHORIZATIONDENIALYN	Indicates whether this authorization has been denied (Y = Yes; N = No).
CANCELLEDYN	Indicates whether this authorization has been cancelled (Y = Yes; N = No).