Prior Authorization Number
What’s in the box?
This box contains the Payer Assigned Number that authorizes the services being billed. If applicable, enter the authorization number assigned by the Insurer for the current date of service. This is only required if the Insurance Company requires pre-authorization for patient encounters.
Where does this info live in Jane?
Prior Authorization Numbers can be set within a patient’s Insurance Policy (Patient Profile > Billing > Insurance Policies > View or New Insurance Policy).
Note: Jane doesn’t have a way of tracking historical/expired/expended Prior Authorization Numbers at this time. When you obtain a new authorization number, you’ll need to manually replace the existing Prior Authorization Number.
If you’ve entered a new Prior Authorization Number in a patient’s Policy, but need to submit past claims under the old Prior Authorization Number, you’ll need to make a manual change before you submit the claim.
Is this required?
This is an optional field when creating an Insurance Policy in Jane.
This is an optional field on the CMS1500.
This is an optional field when billing via EDI file.
What about the EDI file?
If present in the patient’s primary Policy, the Prior Authorization Number is sent in Loop 2300 - Claim Info REF02.
- Note that Loop 2300 - Claim Info REF01 always includes G1 - which is a code that means Prior Authorization Number