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How do I track how many insurance authorization visits a client has left?

Keep one row per authorization with the authorization number, the number of visits the payer approved, and the start and end dates. Count the sessions that actually took place between those dates and subtract them from the approved number. Check it every week, and ask for the next authorization before either the visits or the dates run out.

How to set it up

1. Copy what the payer approved. From the authorization letter or portal, note the authorization number, approved visits, start date and end date. If it's tied to specific CPT codes or a specific provider, note that too.
2. Log every scheduled session, including late cancels and no-shows, with an attendance status. That way you're counting from a full record, not from memory.
3. Count only sessions inside the authorization dates. A session from before the start date or after the end date belongs to a different authorization, or to none.
4. Subtract used from approved to get visits left. Then look at what's already booked: if a client has 4 visits left and 6 sessions on the calendar, you'll run out before the last 2.
5. Set two warnings: one for low visits (for example, 3 or fewer left) and one for the end date (for example, 30 days out). Base them on how long your payers usually take to approve a new authorization.
6. When the new authorization arrives, record the new number and dates. Keep a copy of the old one so you still have the history if a claim is questioned later.

Authorization rules vary by payer and plan: what counts as a visit, which codes are covered, and how early you can ask for more. Check the authorization letter or your payer's provider manual, and call the payer if anything is unclear.

A template that does this

Our Therapist Caseload & Insurance Authorization Tracker ($24, Excel and Google Sheets) does this counting for you. You type each client's authorization number, approved visits and dates once. The Authorizations tab counts attended sessions inside those dates and shows OK, Low visits (with the number left), Ends in N days, or EXPIRED. Late cancels and no-shows don't use up a visit in the tracker. If your payer counts them differently, adjust for that.

Common follow-up questions

Do late cancels and no-shows use up an authorized visit?

Usually only a session that was held and billed counts as a visit, but the payer sets the rule. Check the terms of each authorization. Our tracker counts only sessions marked Attended.

When should I ask for a re-authorization?

Early enough that the new one is approved before the old one ends or runs out of visits. Turnaround varies by payer, so note how long each of your payers usually takes and set your warnings further out than that.

My EHR has an authorization field. Do I still need a tracker?

If your EHR already shows visits left and end dates for every client on one screen, use that. A spreadsheet helps when it doesn't, or when you want one list sorted by who needs attention first.

Related questions

• How do I track no-show and late-cancel fees in private practice?
• What should a therapy insurance claims tracker include?

Sparta Labs templates are spreadsheets for organizing your practice. They aren't an EHR, billing or clinical advice, or a HIPAA compliance solution.