When Should I Create a New Utilization Review? (CMD)

Issue

The patient's authorization has been extended but there is a new authorization number. Should I modify the existing utilization review or create a new one?

Environment

Kipu EMR, Patient Facesheet, Integrated Billing, Roles: Super Admin, Records Admin, Utilization Review Internal, Features: Manage Utilization Review

Resolution

In the following scenarios, we recommend creating a new authorization, rather than extending the current one. 

• When the patient receives a new authorization with a new authorization number. 
• When a new Level of Care is being authorized.
• When the existing Level of Care gets extended with a new authorization number.
• When the patient transitions from one Level of Care to another e.g., Residential to Detox.

Additional Information

For more detailed instructions and information on utilization reviews, users can refer to this article.