Tip: Some of the information displayed on this page is read-only and cannot be changed.Use this page to view and/or print specific and detailed information about an AT authorization.
Tip: Some of the information displayed on this page is read-only and cannot be changed.
The following information is displayed for the AT authorization:
Child ID displays the state identification number of the child.
Child Name displays the last and first name of the child.
Authorization Number displays the file identification number of the AT authorization.
Dates displays the authorized start date.
To displays the authorized end date.
Service Type displays the type of service provided.
Authorization Status displays the current status of the AT authorization.
Authorization Type displays the AT authorization's type.
Date displays the date on which the AT authorization was approved, cancelled, or declined.
Amount displays the approved amount for the AT authorization.
Acct displays the provider account number.
Provider displays the name of the provider account authorized to deliver services.
Print Date displays the date on which the authorization was initially printed.
Parish displays the child's parish of residence.
Service Coordinator displays the name of the care or ongoing service coordinator for the child.
Phone displays the phone number of the care service coordinator.
Head of Household displays the last and first name of the child's head of household.
Phone displays the phone number of the child's head of household.
Comments displays any additional comments on file.
In the columns of the Authorization Line table, view the following information for each line item associated with an AT authorization:
HCPCS Code displays the HCPCS code for the AT authorization.
Description displays the description of the AT authorization.
Quantity displays the authorized quantity.
Price displays the unit price of each quantity.
Total Cost displays the total cost of the AT authorization.
In the columns of the Approved History table, view the following historical information about the AT authorization:
Status Date displays date on which the status was changed.
Status displays the historical status.
Quantity Approved displays the approved quantity.
Price Approved displays the unit price of each approved quantity.
Total Cost Approved displays the total cost of the approved service.
Click the following button(s) as necessary:
Click Print to print the current AT authorization on your printer.
Click Manage Authorization to change the AT authorization's status. This option is only available to users who have access to this feature, and only for AT authorizations that are currently in Pended status.
Click Cancel Authorization to cancel the AT authorization's status. This option is only available to users who have access to this feature, and only for AT authorizations that are currently in Pended status.
Click Return to Auth List to display the AT Authorization List page.
Click Back to return to the previous page.
Click the following link(s) to see how to complete a task step-by-step:
How Do I Cancel an AT Authorization
How Do I Manage an AT Authorization