Tracking Authorizations

Authorizations is the list of what each payor has approved: the number, the code, the hours and units, and the dates it runs between. It replaces a spreadsheet kept by hand and sorted by expiration date.

Authorizations and schedules are two different things#

A schedule is the plan for a patient's care — which days someone visits, for how long, and who goes. It lives on the calendar and it keeps running.

An authorization is the payor's approval. It has its own number, its own dates and its own renewal cycle.

They do not have to agree, and often won't. An extension can take weeks to come back while care carries on as scheduled; the approval usually arrives backdated over the work already done. Nothing in Cadence treats that as an error, and changing one never changes the other. Recording the hours here is recording what the payor approved — a different fact from what the schedule plans.

Recording one#

Use Add Authorization, or the + on any row under Not tracked. What to fill in:

• Billing code — type it; the box suggests codes already in use, but any code is accepted.
• Authorization number — the number this approval came back with. Each approval issues its own, so it belongs to this period rather than to the patient.
• Start and end dates — the end date is the last covered day, and it is required: it is what puts the authorization on the expiration list at all.
• Hours per week and Units this period — the two columns from the sheet. Units are the total for the whole period, not per week. Fill in the hours and the dates and Cadence offers the arithmetic; you can take it or type your own.

The two lists#

Tracked is the worklist: every authorization that has been entered, soonest expiration first. A Ready to send marker appears once a request will actually be accepted, five days before expiry.

Missing is the other list — active patients with no authorization on file at all. Nothing has gone wrong there; it simply hasn't been recorded. Use it to work through onboarding, and to check afterwards that nobody was skipped. Once a patient has one authorization they leave that list for good.

Status#

The tag icon on a row updates its status: Approved, Requested, Missed recert, Missed recert · Requested, or Denied. A note saves alongside it. Each status carries a colour dot, the same one everywhere it appears.

Once a status is set, the row shows how long it has been sitting — "waiting 95 days", turning bold past a month. You don't have to record when you sent anything for that to work.

Two statuses appear on their own and can't be set by hand:

• Lapsed — the end date went by with nothing recorded against it. Renewals get worked before expiry, so this shouldn't happen; when it does it's the loudest thing on the page. Recording any status, or a renewal, clears it.
• Switched — the patient moved to another binder. Read from the switch itself.

An authorization that expires while marked Requested is not Lapsed. You did your part and the payor is slow — turnaround runs weeks to months, and nothing here treats that as a mistake.

Narrowing the list#

Two separate controls, because they answer different questions:

• Show — All, Expiring soon (30 days), or Expired. Read off the end date.
• The status checklist — what the office has recorded. Untick anything you want out of the way.

Renewals#

The refresh icon records an approval that came back. Cadence decides what to do from the dates, and tells you which it will be before you save:

• Still covered — the end date moves out on the same record. The row turns green and drifts down the list.
• Already lapsed — the old authorization stays ended where it ended and a new one starts. The gap between them stays visible, because it is real: the payor had not approved that stretch.

A new period gets its own number, so the box starts empty. Hours and units carry forward unless you enter new ones.

Old authorizations don't get deleted#

When a new approval replaces an old one, the old row disappears from this list on its own — but the record stays. Healthcare records are kept for years, and the old approval is what explains a claim from last spring.

The Delete button inside Edit details is for a record that should never have existed. Even then it goes to the recycle bin, recoverable for 90 days.