Posting UR Decisions back to your RFAs is a critical step in tracking your RFAs and completing the RFA workflow. Plus, it makes the UR Decision easily available to your billers! Read on for directions on how to add UR Decisions to a Sent RFA.
Step 1. Scroll to the Service/Good Requested that received a UR Decision, and click ‘Add UR Decision’
Step 2. Enter the ‘Decision Type’ and ‘UR’ decision date
Step 3. Optional: Enter the Expiration Date and Additional Information
The optional Expiration field allows an expiration date for the service to be entered. If no expiration date was included, select None
The Additional Information field allows for an optional summary of the decision. This field is especially helpful if the Service/Good Requested was modified.
Step 4. Enter UR decisions to other Service/Good Requested
When more than one UR Decision document is received, post each UR Decision received individually. If a certain Requested Treatment does not have a response yet, toggle the ‘Missing’ box.
Step 5. Click ‘Save’
The ‘Save’ button is only clickable when a decision has been added to each Requested Treatment. If the ‘Save’ button is not clickable, ensure that you have a decision listed for all of your Requested Treatments. If a certain treatment does not have a response yet, toggle the ‘Missing’ box.
Step 6. To edit UR Decision, click the Edit icon next to Requested Treatment
Note: UR Decisions from RFAs sent to OneCall cannot be edited or deleted.
Step 8. To delete UR Decision, Click the Trashcan icon
Step 9. Click ‘View’ to view the pdf of your UR Decision