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Continuations: Adding visits/ units and procedure codes to approved auths

Overview

This article explains how to submit continuation requests for services like home health, therapy, and DME requests when updates are needed on an existing authorization*. It outlines two ways to initiate a continuation—either during a new request or from the patient summary—and notes that continuations are reviewed separately but share the same authorization number.

To view the full tip sheet for this feature, click here. To view a demo video of this feature, click here or view the video player at the end of this article.

For a quick overview of the differences in continuations among the payers you are submitting authorizations for, click here.

*Important Note: The details in this article exclude the following payer: Medical Mutual of Ohio

What is a Continuation?

A continuation is a more efficient way to make updates to an approved or partially approved authorization request (such as adding units for a given procedure). All continuation requests will go through a separate review and once decisioned, will have the same authorization number as the initial request.

Which types of services can continuations be submitted for?

You can submit continuations for the following services:

  • Home health

  • Physical therapy

  • Speech therapy

  • Occupational therapy

  • Durable Medical Equipment (DME)

How do I request a continuation?

You are able to request a continuation in two ways:

  1. While starting a new authorization. If similar details were used in a previously approved authorization and the end date has not passed, the request will be displayed, and allow for a continuation to be started immediately.

  2. From the patient summary. Within the patient summary, select “start continuation” next to any eligible authorization. Please note, you can only add procedure codes if they fall under the same clinical service as the initial request.

Once a continuation is submitted you can view details for initial visits and continuations on the patient summary.

Demo Video

Other Relevant Resources

For providers who are contracted with more than one insurance payer, remembering the differences among payer requirements and guidelines can be complicated. Learn more about the differences among payers for the authorizations you submit.

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