A lapse between authorizations means sessions that cannot be billed. The fix is process: stages, owners and an early start.
In short: ABA centers track reauthorization with a board of six stages: upcoming (61 to 120 days before the end date), due (60 days or less), plan of care in progress, ready to submit, submitted and decided. The next authorization starts the day after the old one ends, and lapsed days are shown when no approved successor exists.
The six stages
NeuroOps derives the stage from dates and statuses:
- Upcoming: 61 to 120 days before the end date.
- Due: 60 days or fewer, with no reauthorization started.
- POC in progress: a reauth plan of care exists but is not clinically approved.
- Ready to submit: plan approved, next header still a draft.
- Submitted: next header submitted or pended.
- Decided: approved, partially approved or denied.
Start the next authorization the day after
Create the next draft header beginning the day after the end date and match the reauth plan template to the insurance. Pre-fill authorized and delivered units from the last period.
Show lapses honestly
If the end date passes without an approved successor, display “lapsed N days” on the client and the board.
Control who does what
Admin-level roles create and edit authorizations. A BCBA can draft from an approved plan and start a reauthorization for assigned clients. RBTs have no access to the board.
Make the lead time a setting
Payers differ. Keep the lead time (60 days by default in NeuroOps) as configuration rather than a hard-coded number.
Frequently asked questions
How early should we start reauthorization?
We flag at 60 days before the end date. Check each payer’s submission window.
What if there is no matching plan template?
The next header is still created and the team is pointed to add coverage for that payer.
See the feature page: ABA reauthorization tracking.