Authorization Numbers

Some payers require us to ask for a prior authorization number before submitting a claim. This process involves sending a request to the payer, and receiving a response through Fax with an authorization number, a date range range with its validity, and the number of times it can be used.

Authorization Number persistance

finance_authorization_numbers

Name	Type	Nullable
chart_id	uuid (charts)	No
authorized_service	string	No
valid_from	date	No
valid_to	date	Yes
initial_uses	int	Yes
remaining_uses	int	Yes
code	string	No
authorization_type	string	Yes

Notes

service_type: is a Rails enum, with possible values encounter and outreach. authorization_type: Rails enum, with possible values post_service and pre_service. valid_to: can be null if the authorization code does not expire. initial_uses: can be null if the authorization code has unlimited uses.

Add new FK ref to finance_claims:

Name	Type	Nullable
finance_authorization_numbers_id	uuid (finance_authorization_numbers)	Yes

Usage

class Finance::AuthorizationNumber < ApplicationRecord
  scope :valid_at, ->(date) { ... }
  scope :usable_in, ->(claim) { ... }

  def use_in(claim)
    self.remaining_uses -= 1 if remaining_uses.present?
    claim.authorization_number = self
    save!
  end
end

Related code:

• Finance::AuthorizationNumber model
• Finance::Claim::Authorizable module