5 Reasons Clients’ Authorization Forms Are Denied

Submitting requests for records and bills for your clients’ cases can be a burdensome and time consuming task. There are a multitude of reasons why your requests can be delayed, take extra phone calls and extend your request turn-around time from weeks to months. The major issues that we see that can hold up a request are issues with the initial authorization form and the accompanying paper work. Let’s run through the top five issues that we see on a day to day basis that can hold up your record requests:

 

1.) The Authorization Form is not HIPAA compliant. We see this from time to time where the authorization form is not HIPAA compliant and the provider denies the from, which requires you to restart the entire process and quite possibly take more time to have your client resign another form. Here is a link to our authorization form that we use and rarely run in to issues with a provider. HIPAA form. The Department of Health and Human Services provides an FAQ section to help provide information to ensure your Authorization Forms are HIPAA compliant.

2.) Another issue we run in to is the use of electronic signatures. Some providers will accept digitally signed authorization forms. On the other hand, there are others that will only accept a manually signed authorization form. The HHS provides guidelines for the accepted use of electronic signatures.  DocuSign, who is the most prominent electronic signature provider, supplies a guideline on the use of electronic signatures. Despite all the information and guidelines for the use of electronic signatures there are many providers that will only accept manually signed authorization forms. Which they have every right to, if a provider suspects that a signature does not match the signature they have on file for the patient they can deny the authorization form. Their argument is that they cannot cross reference the manually signed authorization form with the electronic one, so how do they know it is signed by the patient?

3.) Another denial reason we see is that the last name of the patient has changed since they were seen by the provider. This can cause confusion and more work in contacting the client to find out their last name for when they saw this provider, then getting another authorization form signed. People get married, or remarried throughout their lives and their last names change. This is normal, especially if you are getting records from three or four years ago. Easy way to mitigate this is to ask from the beginning.

4.) The authorization form is expired. We see forms that have an expired signature date that makes the form invalid. On every authorization form you must provide an expiration date or time frame for when the authorization will expire. Cases can go on for months or years sometimes, make sure to check the expiration date of the authorization with the date of signature. This simple task could save you time and heartache in receiving a denial for a simple mistake.

5.) Another issue with denials is when accompanying paperwork is not provided. For instance, if someone passed away a death certificate must be provided. If another individual is signing for the patient you need to provide a power of attorney or executrix of the estate in order to prove the validity for the person signing for the records. Make sure to check your signatures and have all documentation sent with the request.

 

A litany of issues can arise from requesting records from providers. These are the most common reasons for denial of your client’s authorization form. Check your paperwork before sending the documentation in order to save yourself wasted time and money in having to redo the documents and start the entire retrieval process over again.