OBJECTIVE: This article provides instructions on how to manage flexible authorizations that have been overutilized in HHAeXchange.
When a caregiver works over their weekly hours, and the ISP has a flexible authorization allowance, this can be adjusted in HHAX-2 by:
- Adding a TEMP authorization for the extra hours worked that week. Use the same authorization details as the active auth and use “TEMP” in the Authorization Number field.
- Subtracting the extra hours worked from the total authorization amount on the active auth.
NOTE: When a Caregiver works under the weekly authorization hours, no change is required.
Week 1: Hours Worked is greater than the Weekly Limit
- Create TEMP Auth for 5 hours, subtract 5 hours from 1,040 total (resulting in total auth of 1,035)
Week 2: Hours Worked is equal to the Weekly Limit
- No change, no change to authorization limit (still 1,035)
Week 3: Hours Worked is less than the Weekly Limit
- No change, no change to authorization limit (still 1,035 with 2 hours available to add to another week)
NOTE: Only pull the amount of units/hours that the auth provides. For example, if there are only 2 hours left in the authorization and the caregiver works an additional 4 hours over the weekly limit, only 2 of those 4 hours are billable. The remaining outstanding 2 hours will not be billable.
Source: West Monroe; HHAeXchange Enterprise Help Portal