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An authorization is a payer’s approval to deliver a set number of service units to a member over a date range. Nothing bills without one.

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Authorizations

Service authorizations with discipline, service codes, date ranges, and unit allocations. Columns: Member · Auth # · Discipline · Service Code · Begin · End · Units · Payer Type · Delivery Model · Cap Units · Used · Status

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The fields that decide whether a visit bills

Used approaching Units is the single most useful early warning in OfficeRidge. Once units are exhausted, delivered visits stop being payable — the care still happened, but you cannot bill it. Request a new authorization before you reach the cap, not after.

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Watch the end date too

Members whose authorization is nearing expiry take the status AUTHORIZATION_HAS_EXPIRY_DATE. Treat that as a prompt to start the renewal, not a notification that renewal is complete.

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Service Items

Individual service delivery items for bathing, feeding, medication assistance, and more. Columns: Member · Status · Bathing · Feeding · Meds · Checked Service items record which specific tasks the member receives. They describe the content of care, where the authorization describes the permission and quantity. Checked indicates the item set has been reviewed and confirmed for that member.

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Recording an authorization

1

Confirm the payer

The payer must exist and be active. See Care network.
2

Enter the authorization number and service code

Copy them exactly from the payer’s approval. A transposed service code produces denials that are tedious to unpick.
3

Set the date range and units

Record Begin, End, Units, and Cap Units as approved.
4

Set the status to active

Scheduling checks authorization status before allowing billable visits.
5

Confirm service items

Record what the member actually receives on the Service Items tab.

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How authorizations reach billing

Scheduling is authorization-aware: it flags visits that fall outside the authorized window or exceed remaining units. See Scheduling.

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Troubleshooting

Scheduling

Authorization-aware conflict tracking.

EVV to paid claim

The full chain from authorization to payment.