Note: This page can only be displayed by specific users who have access to this feature. Some of the information displayed on this page is read-only and cannot be changed.Use this page to create a new AT authorization for a child's record.
Note: This page can only be displayed by specific users who have access to this feature. Some of the information displayed on this page is read-only and cannot be changed.
Complete the following information as necessary:
In Child ID, enter or select a child ID.
Child Name displays the last and first name of the selected child. This information is read-only and cannot be changed.
Service Type displays type of service that is being created. This information is read-only and cannot be changed.
Authorization Type displays type of AT authorization that is being created. This information is read-only and cannot be changed.
In Active Date, enter or select the starting date for the AT authorization.
In To, enter or select the ending date for the AT authorization.
IFSP Periods displays all of the IFSP periods for the selected child's record. This information is read-only and cannot be changed.
In HCPCS, enter or select an HCPCS Code for the AT authorization.
Description displays a description of the HCPCS Code entered or selected. This information is read-only and cannot be changed.
In User Description, enter a description of the user for the AT authorization.
In Type, select the type of service being used for the AT authorization.
In Quantity, enter the number of units necessary for the AT authorization.
In Price, enter the price per unit for the AT authorization.
Total Amount displays the total dollar amount for the AT authorization. This information is read-only and cannot be changed.
In Comments, enter any additional comments about the AT authorization.
Note: You must specify either NPA Provider or Provider to complete the AT authorization. Selecting the Provider radio button will enable entry and selection in the fields under Provider.. If no provider is available for this AT authorization, select the NPA Provider radio button.
To specify a specific Provider, click the 
icon next to Account ID to search for a specific provider on the Search Provider page. Once a provider is selected, the page is refreshed and the following information displays under Provider based on your selection:
· Account ID displays the provider's account identification number.
· Payee Name displays the name of the payee on the provider account.
· First Name displays the first name of the provider.
· MI displays the middle initial of the provider.
· Last Name displays the last name of the provider.
· Phone displays the provider's phone number
· Specialty displays the provider specialty.
Click the following button(s) as necessary:
Click Reset to clear any unsaved changes and restore the previously displayed information.
Click Back to return to the previous page.
Click Save to save information that has been changed.
Click the following link(s) to see how to complete a task step-by-step: