Show:
Authorized
Submitted to Insurance
Pending Review
Denied
Closed
100
Authorization has been obtained for a specific procedure/test
What is Covered Benefit?
100
PA Staff determines that a test/procedure is not a covered benefit under the patient's insurance plan
What is Not a Covered Benefit?
100
The Payor does not backdate referral authorizations
What is Retroactive Referral Request?
100
Patient declines or refuses services.
What is Patient Refused?
200
Authorization number has been obtained for Physician to Physician referrals
What is Received Carrier Authorization?
200
Patient has a newborn pending insurance type, needs to contact financial clearance.
What is Newborn Pending Enrollment?
200
Referral is truly a duplicate and needs to be closed.
What is Duplicate Referral Request?
200
Scheduling status in the referral is set to scheduled external and the patient is being seen elsewhere.
What is Treatment Complete?
300
Authorization number not obtained, but practice will still see the patient by provider's request.
What is Provider Authorized?
300
Used for non-web payors after the authorization request has been submitted via fax or phone and staff is waiting for a response.
What is Submitted to Insurance?
300
PCP listed is invalid or incorrect and needs to be updated. Patient access staff will contact the patient to confirm.
What is Invalid/Incorrect PCP?
300
Service required is truly not a covered benefit under the patient's insurance.
What is Not a Covered Benefit?
300
When the order that generated the referral gets cancelled by the provider.
What is Order Cancelled-Auto Closed?
400
Authorization not required by Insurance
What is No Approval Necessary - Patient Tracking?
400
Clinical information is missing from referral.
What is Needs Medical Review?
400
PA Staff will use when they are unable to contact the referring practice, will flag referral.
What is Unable to Contact Referring PCP?
500
No referral is needed, consult or procedure/test is automatically authorized by system.
What is System Automatically Authorized?
500
Patient's Insurance is a non-contracted payor for BMC
What is Facility/POS Not Contracted?
500
System will automatically close the referral if the patient is marked as deceased.
What is Patient Deceased?