VEDA
Search and Request
For hospitals pre-authorisation is an essential part of invoicing but can be a time-consuming and laborious manual task. Using our automated service to securely pre-authorise eligible Aviva and Vitality patients for treatment is easy. Please remember that receiving pre-authorisation from the insurer is not a guarantee of payment – it simply means that the patient’s policy allows them to have the requested treatment.
To help you streamline your work, there’s a Pre-Auth section on the Status Page that shows you numbers of Accepted and Unread pre-authorisations. Clicking on one of these will take you directly to the relevant list.
Everything is available from the Pre-Auth tab. Clicking on this gives you two options:
- Find/ Request to search for a pre-authorisation for a specific patient or to request a new one
- List Pre-Auths to either view all pre-authorisations for a specific patient or to search for all pre-authorisations received on a certain date or within a 30-day date range
All pre-authorisations will have a status:
- Unread – this is a new pre-authorisation that has been sent through to you but no-one from your hospital has marked it as read yet
- Read – this pre-authorisation has been reviewed by someone at your hospital but it hasn’t been accepted yet
- Accepted – someone at your hospital has accepted the details
- Requested – a request sent by you that hasn’t been authorised by the insurer yet (the pre-authorisations showing this status are only available when using the List Pre-Auths option)
Search for an existing pre-authorisation
Click the Pre-Auth tab and then click Find/ Request. You’ll need to complete the search parameters in the top Select Patient section – use the keyboard tab key for faster navigation. The fields required are:
- Family Name
- First Initial
- Gender
- Date of Birth
- Postcode
- Insurer
If you already know the pre-authorisation code you can search using the following four fields:
- Auth. Code
- Gender
- Date of Birth
- Insurer
Click Search and all available pre-authorisations for that patient will be listed in the bottom Pre-Authorisation List section.
Viewing
Click on the required pre-authorisation and both the Selected Patient Details and Pre-Authorisation Details sections will be filled.
The patient details section will include the policy cover type and the start and end dates. The pre-authorisation details section will include the authorisation code, the issue date and a Network Inclusive Package indicator.
Clicking on the + symbol next to the service(s) in the Service Items section will display important pre-authorisation details:
- Setting – whether Daycase, Inpatient or Outpatient
- Treatment From Date
- Treatment To Date
- Authorised From – the start date of the approved treatment period
- Authorised To – the end date of the approved treatment period
- Procedures – the approved procedure(s)
- Treatment Sites – the approved treatment site(s)
- Specialists – the approved practitioner
You’ll see a Notes section at the bottom. This is where any queries you’ve sent to the insurer will be saved. See the section below on Sending a query to find out more.
Changing the status
You can only change the status of a pre-authorisation that you’ve received from the insurer. Make sure you’re viewing it and then click on the Change Status drop-down menu at the bottom of the screen. Your hospital may have a process to follow to determine when these statuses are changed and/or who should do this.
Sending a query
You may need to ask the insurer for some clarification on what they’ve authorised or perhaps you’ve got to make some changes to your request. This is easily and securely done.
The status of the relevant pre-authorisation must be Accepted, so you may need to change this first (see above). Click Query – found next to the Change Status box at the bottom of the Pre-Authorisation Detail pane. This opens a text box for you to type in anything you want the insurer to review. Once ready click Submit Query – you’ll now see the text in the Notes section and the insurer will be sent all the information to review.
They’ll respond using Secure Messaging if they have any questions or will make a new pre-authorisation available to you. Just regularly check your Status Page for updates.
Printing
Click Print at the bottom of the Pre-Authorisation Detail pane. This will generate a PDF that you can download and will work whatever the status.
Copying
Whatever the status, you can copy a brief summary of the pre-authorisation to your clipboard and paste where required. Click Copy at the bottom of the Pre-Authorisation Detail pane.
Request a new pre-authorisation
Before requesting a new pre-authorisation you should check that the patient has been in contact with the insurer first.
Click the Pre-Auth tab and then click Find/ Request. You’ll need to complete the search parameters in the top Select Patient section – use the keyboard tab key for faster navigation. The fields required are:
- Family Name
- First Initial
- Gender
- Date of Birth
- Postcode
- Insurer
When you click Search if no existing pre-authorisations are found the new pre-authorisation request form will automatically open on the right-hand side of the page. If there are existing pre-authorisations simply click Request New to open the form.
The fields with a red asterisk are mandatory:
- Service Code – choose from the drop-down menu
- Setting – choose from the drop-down menu
- Treatment From Date – the date the patient is expected to come into the hospital for treatment
- Treatment To Date – the date the patient is expected to leave the hospital after treatment
- Treatment Site – where the treatment will take place
The Inpatient Nights field will automatically calculate depending on the dates you’ve entered.
The more information you give helps the insurer decide whether to authorise without needing clarification. The additional areas available are:
- Condition (ICD)
- Click on the + symbol
- A separate window will open – search for the diagnosis using the code (if you know it) or the description
- Highlight the correct one and click Select to add
- Procedures
- Click on the + symbol
- A separate window will open – search for the procedure using the code (if you know it) or the description
- Highlight the correct one and click Select to add
- Treatment Site
- This will default to your hospital unless you are controlling more than one, in which case you can choose from the drop-down menu
- Controlling Specialist
- Click on the 0 symbol
- A separate window will open – search for the practitioner using at least one of the available filters: First Name, Last Name, Specialty and Prof. Code (e.g. GMC registration number)
- Click Search
- The practitioners who match your criteria and are mapped to your hospital will be listed in the Search Results box
- Highlight the correct one and click Select to add
Click Add Service Item to add to the Service Items list. You can add further service items if required.
You can now click Save Pre-Auth at the bottom of the pane to submit it – at the top of the screen you’ll see a message in a green box showing you that your submission has been successful.
When the insurer receives your request it will either issue a pre-authorisation or will respond using Secure Messaging for further clarification. Just regularly check your Status Page for updates.
List pre-authorisations
Click the Pre-Auth tab and then click List Pre-Auths. You’ll need to complete the search parameters in the top Search Pre-Auths section – use the keyboard tab key for faster navigation.
To list all the pre-authorisations for a specific patient simply type at least three characters in at least one of the following fields.
- Family Name
- Membership Number
Typing in the Auth Code (if you know it) will only list the pre-authorisations that used it.
To list all the pre-authorisations issued on a specific date or within a 30-day date range simply type in the relevant dates into the Issue Date and to boxes.
You can refine your search further by using three more filters:
- Status – change from All to
- Unread
- Read
- Accepted
- Treatment Site – useful if you can see pre-authorisations for multiple hospitals
- Type – change from All to
- Received only – the pre-authorisations you’ve received from the insurers
- Sent only – the pre-authorisations you’ve requested but haven’t had approved yet
Once you’ve set your parameters click Search to see all the matched results. Follow the steps above for Viewing.
Want more support?
We’ve put together a video playlist that may be useful to see these processes in action.
