Authorization Status Inquiry Walkthrough

Overview
Authorization Status Inquiry allows the user to check the status of an authorization request that has been submitted to a payer. The following is a step by step walkthrough of performing an authorization status inquiry.

Quick Notes

• The Requesting Provider is required. This is the provider that was used when making the initial authorization request.
• The Member Number or Authorization ID Number is required.
• Start & End Dates are required, in addition to the member data.
• Additional information can be found in the Referral/Authorization Inquiry Tip Sheet

Submitting a Simple Referral Request Status Inquiry

1. Click on Referral / Authorization Status Inquiry in the HEALTHeNET menu

2. Select the Payer from the drop-down

3. Select the Requesting Provider
Note: The same provider that was used to submit the initial authorization request.

4. Enter the Inquiry Information
Note 1: The information should match what was submitted with the initial authorization request.
Note 2: There are two types of Authorization Inquiry types: Admission & Health Services Review.

5. Click on the SUBMIT button

Submitting an Authorization Status Inquiry for a Dependent

1. Click on Referral / Authorization Status Inquiry in the HEALTHeNET menu

2. Select the Payer from the drop-down

3. Select the Requesting Provider
Note: The same provider that was used to submit the initial authorization request.

4. Enter the Inquiry Information
Note 1: The information should match what was submitted with the initial authorization request.
Note 2: There are two types of Authorization Inquiry types: Admission & Health Services Review.

5. Enter the Dependent Information
Note: The information must match what was originally submitted.

6. Click on the SUBMIT button

Conclusion
This document covers the basic use cases for the Authorization Status Inquiry screen and the required fields for each. There are additional request fields on the inquiry screen that can be included to assist the payer with identifying the authorization request.