Staff - Authorization Management Guide.pdf

Table of Contents

Authorizations

Authorizations Overview

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How Authorizations are Created

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Users with a Supervisor role with or without the Authorization Admin Permissions can see authorization information from multiple sources:

Viewing Authorizations - Authorizations Widget

Viewing Authorizations - Authorizations Widget

The first way is by The first way is by using the Authorizations Widget on the Home Screen.

Type in the client (consumer’s) name and a date. Click search to see the authorization for the current pay period.Image Removedall authorizations this consumer has that contain the specific date you entered.

Viewing Authorizations – From the Consumer’s Profile

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1. From the client (consumer’s) profile, scroll down until you see the Entries.
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2. From the Select Type dropdown, select Authorization.
3. Optional: Enter From and To dates for which the authorizations shown will start and end.
4. Click Search.
5. This will show all authorizations for this consumer in the system. You can use the service code to determine which provider the authorization is for.
6. If you have the Authorization Admin Permissions, click on the Id of an authorization to see more information.Image Removed
7. This will show all authorization information including:
   1. Start and end date of the voucher
   2. Initial Balance for the voucher
   3. Remaining Balance
   4. Pre Authorization Holds
   5. Voucher Number
   6. Provider Number

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Viewing Authorizations – Authorization Entries Report

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1. Click the Reports tab.
2. Select Authorization Entries Report from Authorization Reports.
3. Enter Search information, check Include Ended Authorizations, and Click Search.
4. Review the results below.

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If you do not have the Authorization Admin Permissions, this report is the only way you can see full details about an authorization.

Viewing Authorizations – Authorization Tab

The fourth way is by viewing the authorization in the Authorization Tab. This method will be covered in detail in the section Editing Authorizations.Image Removed

This tab is only available to those who have the Authorization Admin Permissions. If you have this permission, you will see “Authorization” listed next to the Home tab.

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• There is a need for a permanent switch in provider(s) during a pay period.
• There is a need for a one-time switch in provider(s) during a pay period.
• A provider has been terminated during a pay period and has already worked hours.A consumer consumer has multiple providers with varying hours.
• An exception to increase a provider’s weekly cap was approved, resulting in a change to the authorized hours.
• A change/update in an authorization is needed such as:
  • Change in hours
  • Change in mileage
  • Change in end date

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• Complete (fill out, sign, and print) required forms (546SF, 546N, or 546PC) if this form is applicable to your office.
• Create and distribute a 598-task list, if there is a new provider involved, such as if there is a switch in providers.
• Narrate in OA the 546 information.
• Void the current voucher(s) and create a new voucher(s) in the Mainframe.
• *For permanent change in provider, end the current ONGO and create a new ONGO with the new information.

How to Edit an Authorization

1. Click Authorization at the top of the screen.
2. Click Authorizations on the left.

3. Enter the consumer’s name and click Search.

   Note
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   If the search shows more than one consumer with the same name, you can filter by adding your cost center.

4. Click on the authorization you need to edit. To the right of each authorization in the Authorization ID Reference column, you will see the voucher number. You can use this to identify the authorizations you want to edit.
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5. Click Actions in the upper-right corner.
6. Click Edit Authorization to open Edit Authorization window.
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7. Enter the Voucher Number from Mainframe into the Authorization ID Reference.
8. Verify the provider number is correct in the Authorization ID Reference 1. If it does not match, verify this is the correct authorization. You should never edit the provider number.
9. Verify date of authorization.
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10. Initial Balance, Monthly Max, Weekly Max and Daily Max will be the number of hours or mileage approved (they will all be the same number).

11. Click Save.
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    Note
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    When a new voucher number is created in Mainframe, make sure to enter the new Voucher Number in OR PTC DCI in the Authorization ID Reference field!

12. Click Yes on the Confirmation Alert.
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    Note
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    If you just updated the hourly authorization, you must now update the mileage authorization (even if the miles did not change) so the voucher number matches and vice versa.

Splitting Vouchers

You may need to split a voucher if the number of hours a provider is authorized for a given consumer changes in the middle of a pay period. To split a voucher, follow the steps outlined below:

How to Edit an Authorization

1. Click Authorization at the top of the screen.
2. Click Authorizations on the left.
3. Enter the consumer’s name and click Search.
4. Click on the authorization you need to edit. To the right of each authorization in the Authorization ID Reference column, you will see the voucher number. You can use this to identify the authorizations you want to edit.
5. Click Actions in the upper-right corner.
6. Click Edit Authorization to open Edit Authorization window.
7. Enter the Voucher Number from Mainframe into the Authorization ID Reference.
8. Verify the provider number is correct in the Authorization ID Reference 1. If it does not match, verify this is the correct authorization. You should never edit the provider number.
9. Verify date of authorization.
10. Initial Balance, Monthly Max, Weekly Max and Daily Max will be the number of hours or mileage approved (they will all be the same number).
11. Click Save.
12. Click Yes on the Confirmation Alert.

Splitting Vouchers

You may need to split a voucher if the number of hours a provider is authorized for a given consumer changes in the middle of a pay period. To split a voucher, follow the steps outlined below:

1. Void the original voucher in Mainframe. Put the voucher in ‘10’ status in Mainframe.
2. Edit the existing authorization(s) in OR PTC DCI, so it ends on the desired date. (If doing a split voucher period). This means, edit the hours and mileage down to match what the new amounts should be and change the end date for both the hourly and mileage authorizations. Editing the original authorization(s) end date in OR PTC DCI before creating the new voucher in Mainframe will prevent the system from thinking there are overlapping vouchers/authorizations. Make sure to update both the hourly and mileage authorizations if both exist. To do this, follow the steps in How to Edit an Authorization.
3. Create the new vouchers in Mainframe.
4. Edit the authorization(s) in OR PTC DCI once more to update to the newly created voucher number. Also verify that the hours/miles and end date are correct
5. Void the original voucher in Mainframe.
6. Create the first of the two new vouchers in Mainframe. The first new voucher starts on the same day as the original start date, and ends in the middle of the pay period
7. Edit the existing authorization(s) in OR PTC DCI to match the new hours/miles, voucher number, and end date. Do not edit the expiration date. If the voucher had both hours and miles, make sure you update both authorizations, so the voucher number and end date are correct. To do this, follow the steps in How to Edit an Authorization.
8. Create the second new voucher in Mainframe, meaning the one starting in the middle of the pay period. This second authorization will be automatically created in OR PTC DCI if step 3 was done first.
9. Confirm the authorization information has properly been updated/created in OR PTC DCI and ensure both vouchers/authorizations match between Mainframe and OR PTC DCI.

Process and Reasons for Rejecting Authorizations

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An authorization can only be rejected if no entries have been created against on the authorization. To reject an authorization:

1. From the Authorizations Tab, click on Authorizations.
2. Use the search filters to find the authorization you wish to reject.
3. Click on the authorization. In the Authorization ID Reference column, you will see the voucher number. You can use this to identify the authorizations you want to edit.Image Removed
4. Click Actions.
5. Select Reject Authorization.Image Removed

What if an authorization was made in error but there are already entries in the system against the authorization?

• Void the voucher in Mainframe.
• You will not be able to reject the authorization.
• Instead, you must cancel all entries on the authorization that were inaccurate.
• Once all entries are canceled, follow the steps discussed in How to Edit an Authorization to edit the authorization.
  • Change the end date on the authorization to match the begin date and reduce the initial balance and daily, weekly, and monthly max to 0.01.
• If some entries cannot be canceled because they were valid, follow the steps to edit the authorization.
  • Change the end date on the authorization to match the date of the latest entry made and reduce the initial balance and daily, weekly, and monthly max to the prorated amount.
  • For example, if the most recent entry is for July 1, 2021, change the end date of the authorization to July 1, 2021.

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• The Agency is sending authorizations to OR PTC DCI through an automated interface. If a funding account does not exist in the system, the authorization will fail. This authorization failure notifies the PTC Support Team to create the appropriate accounts, including the funding account. This process can take up to two business days.
• If it has been more than two business days (the day you created the voucher does not count as a business day) and you notice the consumer still does not have a funding account and profile, you should complete the Consumer/Provider Profile Maintenance Form and email it to the PTC Support Team at PTC.Support@odhsoha.oregon.gov.
• If it has been more than two business days (the day you created the voucher does not count as a business day) and you notice the consumer still does not have a funding account and the consumer does have a profile, you should email the Consumer/Provider Profile Maintenance Form with Consumer information part 1 and Provider information part 1 filled out to the PTC Support Team at Support@odhsoha.oregon.gov asking for the funding account to be created. Note

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  Please do not notify the PTC Support Team until after waiting two business days after the voucher was created in DHR (this step is completed after creating the service plan). Please include the voucher number and voucher creation date on the formPTC.Support@odhsoha.oregon.gov asking for the funding account to be created.

When is a Funding Account Created?

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• A new consumer is approved for services and selected a provider.
• An existing consumer is receiving a new service.
• A consumer has hired a new provider in addition to their current provider(s), even for a temporary change.
  • See Business Processes 1.1.2 and 1.1.3 for Permanent and Temporary Switch in Providers During Pay Period. Note

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    If profiles, authorization, service, and funding accounts are not set up by the time the provider starts working, the provider may need to create historical time entriesPermanent and Temporary Switch in Providers During Pay Period.

Common Funding Account Edits

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1. Navigate to the consumer’s profile via the Clients tab.
2. Scroll down and click on the Accounts tab.
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3. You can use the search function to filter funding accounts associated with this consumer.
4. Funding accounts are labeled as Client Funding in the Account Type column.

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Service Accounts

Service Account Overview

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• A new consumer is approved for services and has selected a provider.
• An existing consumer is receiving a new service.
• A consumer has hired a new provider in addition to their current provider(s), even for a temporary change.
  • See Business Processes 1.1.2 and 1.1.3 for Permanent and Temporary Switch in Providers During Pay Period.

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• The PTC Support Team will create the service account when they create the funding account. If it has been more than two business days (the day you created the voucher does not count as a business day) and you notice the consumer still does not have a service account nor do they have a profile, you should complete the Consumer/Provider Profile Maintenance Form and email it to the PTC Support Team at PTC.Support@odhsoha.oregon.gov.
• If it has been more than two business days (the day you created the voucher does not count as a business day) and you notice the consumer still does not have a service account and the consumer does have a profile, you should email the Consumer/Provider Profile Maintenance Form with Consumer information part 1 and Provider information part 1 filled out to the PTC Support Team at Support@odhsoha.oregon.gov asking for the service account to be created. Note

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  Please do not notify out to the PTC Support Team until waiting 2 business days after the voucher was created in DHR (this step is completed after creating the service plan). Please include the voucher number and voucher creation date on the form.at PTC.Support@odhsoha.oregon.gov asking for the service account to be created.

Indicators a Funding Account and Service Account Aren’t Set Up

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1. Verify consumer information.
2. Scroll down and click Accounts.
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3. Click on the service account you wish to see the details for.Image Removed

Multiple Providers

If a consumer has multiple providers, the consumer will have multiple authorizations with the same service code, except for the number at the end of the service code.

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Notice that there are two different hourly service codes in the Service Code field: Hourly ADL/IADL- 1 and Hourly ADL/IADL-2. The 1 and 2 distinguish which provider that service code is associated with, this is used in the Authorization Tab and on the Authorizations Widget in lieu of the provider’s name.
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If you have a consumer with multiple providers that have varying hours, you must update the authorization with each hours change. For more information, see 6.1.0 Business Process - Case with Multiple Providers and Varying Hours.

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