How to Manage Client Authorizations in ElderSuite

📝 Overview

Each client's prior authorization lives on the client record—not in a separate authorizations list. Keep Authorization No., Authorization Date, Authorization Expires, and Authorized Units current so staff can see what remains and claims can carry the number payers expect.

ElderSuite serves adult day care centers nationwide.

Open Client Center → Client List, select the client, then Edit Client (or double-click the row). On Client Information, open the Admission Info tab and the Payment Settings inner tab. The fields sit in the Authorization Information section.

Start Date and Withdrawal Date stay on the Admission Dates inner tab. When a payer issues a new authorization, update the authorization fields—leave the client's Start Date alone. That date is admission history, not billing data.

New clients begin in How to Add a Client in ElderSuite. Payment types are maintained separately in How to Manage Payment Types in ElderSuite. After the number is on the client, How to Scrub Claims in ElderSuite and How to Process Claims in ElderSuite cover moving claims forward.

⚙ How It Works

1. Open the Client

Open Client Center from the ElderSuite main menu and click Client List.

Select the client, then click Edit Client, or double-click the client's row. Client Information opens for that client.

For a Limited Access sign-in, Edit Client needs the Edit Clients permission on the employee record in the Provider Center. Without it, the button is grayed out. Permissions are read at sign-in, so sign out and back in after the permission is granted. Closing and reopening Client List alone is not enough.

Only one Client Information window can be open at a time. Opening another client closes the first first, so finish or discard unsaved work before you switch.

2. Open Payment Settings

Click the Admission Info tab, then the Payment Settings inner tab.

Arriving on Payment Settings recalculates Remaining Units for the client on screen. That figure is not recalculated when Client Information first opens on another tab.

3. Enter the Authorization Fields

In Authorization Information, update:

• Authorization No. — the payer's authorization reference, up to 25 characters. Clicking into the box selects the whole value, so the first character you type replaces it. Click again inside the box to change only part of it.
• Authorization Date — when the authorization starts. Remaining Units cannot be worked out without it.
• Authorization Expires — when the authorization runs out.
• Authorized Units — how many units the payer approved for this authorization.

Remaining Units is calculated and never typed. It is Authorized Units less units already billed for this client—attendance records with a claim status of Submitted or Paid dated inside the authorization period. A blank figure means it could not be worked out. A dark red figure means more has been billed than the authorization allows. Use the What's this? link beside Remaining Units for the on-screen explanation.

Leaving Authorized Units, Authorization Date, or Authorization Expires after a change recalculates Remaining Units from what is on screen, including edits you have not saved yet.

4. Save & Close

Click Save & Close (or press Alt+S). That is the only command that saves on this window—nothing is saved as you type. A please-wait message appears while the record is written, and the window closes when the save succeeds.

5. Watch the Client List Indicator

Back on Client List, select the client and read the authorization indicator on the Client Information panel. It is a countdown driven by the expiration date on file:

• Unknown Authorization Expiration Date (black) — no authorization expiration date is recorded. That is not confirmation that the authorization is fine, and it is not confirmation that it has expired.
• Authorization Expired (red, checked) — the date is today or earlier.
• Authorization Expires in [n] Days — black when 31 or more days remain; red when fewer than 31 days remain.

Red means action is needed—either the authorization has already lapsed, or it lapses within 31 days. The indicator is hidden for some payment types (including payment types with no payer attached). Absence of the indicator does not mean the authorization is healthy; check the dates on the record.

6. How the Number Reaches Claims (Box 23)

On the CMS-1500 / Health Insurance Claim Form, the number appears as 23. PRIOR AUTHORIZATION NUMBER (Box 23). Payers may call it a prior authorization number or a referral number.

When Box 23 is blank and the client record carries an authorization number, ElderSuite fills Box 23 from the client during scrubbing (including Scrub & Fix on Pending claims) and during the automatic claim check. You can also type Box 23 directly on the claim, up to 25 characters.

The scrub fills Box 23 only when it is blank—it does not overwrite a value already on the claim. Editing Box 23 on one claim changes that claim only. Future claims keep using the value on the client record until the client record is corrected.

A missing prior authorization number is not one of the gold-highlighted claim checks. A blank Box 23 raises no scrub error flag and can go out empty if the client record has no number either.

✅ Important Limitations

ElderSuite does not check Authorization Expires against Authorization Date. An expiry earlier than the authorization date saves without warning—double-check the dates before you save.

A blank Box 23 is never marked gold and does not raise an error flag. If the client record has no authorization number and Box 23 stays empty, the claim can still save and be submitted.

Remaining Units counts only what has been billed through ElderSuite with claim status Submitted or Paid inside the authorization period. It counts down from the Authorized Units you entered. After a denied claim is reconciled, those units stop counting as used and the figure can go back up on its own. The payer's own denials remain the dependable sign that units have run out.

The Client List authorization indicator does not appear for every payment type. Missing wording is not proof the authorization is current.

⚠ Authorization Dates Are Not Cross-Checked

ElderSuite accepts an Authorization Expires date earlier than the Authorization Date without complaint. Nothing on this window catches a transposed date for you.

💡 Need More Help?

For step-by-step assistance, click Ask Eddie from within ElderSuite.