ADDING THE PRIOR AUTHORIZATION NUMBER TO THE HCFA LAYOUT

If you have not made any customized changes to your billing template ( changed where boxes are printed or adding additional fields) you have the ability to reset this form to the default layout. This default layout is already set with the 4 digit year in all date fields and is set to pull the Carrier ID for Doctor if filled in, or the UPIN number from the Doctor Information is Carrier ID for Doctor is blank. It also pulls the Prior Authorization Number field from the Claims area into box 23 of the HCFA form. If you have customized your template, then you must manually edit this field.

Reset to Default Layout

Close all open windows. Open the Reports Menu. Arrow down the list until you see the HCFA General Red 1.7. Click ONCE to select this template. Now click on the button [Restore Default].

NOTE: If you do not see the [Restore Default] button, check with your office manager or network administrator. It will mean that your log in does not contain the rights for this action.

This will pull up a window with several templates listed. It should already be highlighted on HCFA General Red 1.7, if it is not, highlight this line. Now hold down the CTRL key and press the letter “W” to save this restore. This will now be set to fill in all required blanks on the HCFA form with the fields requested. The dates will include the century and the Carrier ID will fill in for box 33 if applicable.

Manually Adding this Field

The easiest way to edit this form is to do this from billing. In this way, we can test to be sure that everything is doing what we need. Once in billing, pick a patient with which to test. It is best if the patient already uses the form we are editing. Now click on EDIT. This brings up a screen with all the small “boxes”.

Just above the gray bar titled “Page Header”, you will see four boxes (two and two above each other) the look something like [UPPER(CH]. These will be the Diagnosis entries. Box 23 (in which Prior Authorization Number needs to appear will be to the Right Hand Side across from the second row of diagnosis entries. Right now the entire right hand side is empty. Click on ONE of the Diagnosis boxes once to highlight this box. Now hold down the CTRL key and press “C” to copy this box. Now hold down the CTRL key and press “V” to duplicate or paste this box onto the screen. It will appear slightly overlapping the original box. Use the MOUSE or the right arrow key to move this box to the right hand side (approximately between the 2 [U] boxes on the [UPPER(PMCLAIM.HCFA_BOX_19)] box but directly across from the diagnosis lines. Once you have this box in place, hold down the SHFIT key and use the Right Arrow key to make this box a little bigger.

Double click on this box to bring up the Expression area. Now click on the button to the right of the Expression ([…]) to expand this expression. You should see the following:

UPPER(CHRTRAN(LEFT(DIAGNOSIS((2)+2),7),"./,"," "))

To correct this to the proper expression, you will correct this to read as follows:

UPPER(CHRTRAN(PMCLAIM.PRIOR_AUTH_NUM,"./,"," "))

When you have corrected this field expression, OK you way back to the screen with the “boxes”. It should look something like the following example. Now hold down the CTRL key and press the letter “W” to save this format.