AHCA BA Provider Alert: Recommended Workflow for Providers who are Missing Prior Authorizations from EQs

 

Recommended Workflow for Providers who are Missing Prior Authorizations from EQ

1. Providers must report missing recipients and PAs only for H2012BA, H2014BA and H2019BA via Excel spreadsheet to Tellus (H0031 and H0032 is not applicable to EVV).
2. If the agency administrator cannot find a PA in the Tellus EVV system when searching by Recipient name, the agency administrator must then search by PA# only. If no recipient data found, report missing recipients to Tellus via Excel.
3. If the PA is not automatically attaching itself to the Work List when billing, causing “Unmatched Status”, the agency admin can REMATCH the visit as a refresh or manually enter the PA# as an override (this is only when the PA# is found).
4. If the PA is not found in the system, that does NOT prohibit the provider agency from scheduling and providing service; providers are encouraged to continue service. However, providers will not be able to bill for the service until the PA is in their account.
5. If the recipient is not found in the system, providers can still provide service without scheduling in Tellus. Once the recipient is added, the agency administrator can retro-schedule and manually complete the visit. Alternatively, the agency administrator can select “New Claim” in the Work List to create the visit and bill.

 

Additional Information:
To view additional training materials please go to https://mobilecaregiverplus.com/ahca-ba and select the Training & Resources tab. If you have questions regarding training or system registration you may contact TELLUS at: 1.833.622.2422.