Prior Approval Items

The Prior Approval Items contains information about requested service lines. There are several different formats of the Prior Approval Items depending on the PA type. Several PA types share the same format. Every PA type's Prior Approval Items tab has a view containing a list of service lines. Each service line has a Line (line number), Determination, Reason, and Effective Date Range field and a More Details button. Many field labels include 'App'd' in the text; this means 'Approved'. Most of the formats include an App'd Amount field. This field is the dollar amount requested.

Choose More Details on one of the lines and the list of service lines is replaced with a More Details view of the selected line. The More Details view contains a Reviewer Comments field and a Close button within the shaded area. Choose this Close button and you are returned to the service line list view of the Prior Approval Items tab.

Bed Reservation/Nursing Home

In general you will only see a single service line on the Prior Approval Items tab for the Bed reservation/Nursing Home PA type. In addition to the standard fields, tabs for this PA type include an Approved Period of Service field composed of From and To sub-fields.

Dental

In addition the standard fields, the Prior Approval Items tab for the Dental PA type includes a Service Date, Proc & Modifier, Dental Arch/Quad, Tooth Number, App'd Times, and a App'd Amount field.

DME/Supplies, PDN

The Prior Approval Items tabs for the DME/Supplies and PDN PA types are identical. These tabs contain a Service Date, Item/Proc & Modifier, App'd Quantity, App'd Times, and an App'd Amount field in addition to the standard fields.

Eye Care, Hearing Aid, Physician

The Prior Approval Items tabs for the Eye Care, Hearing Aid, and Physician PA types are identical. In addition to the standard fields, these tabs include a Service Date, Item/Proc & Modifier, App'd Quantity, and an App'd Amount field.