An authorization gives the provider the authority to supply goods or services to a VR consumer.
- An authorization must be completed in QE2 prior to the time the goods or services are provided. Verbal authorization is permitted, but does NOT negate the requirement that the authorization be completed in QE2 prior to the goods/service being provided. NOTE: In unforeseen circumstances, an authorization may not be able to be completed in QE2 prior to the good or service being provided, If this occurs, a task entry must be made by the office director explaining the reason the authorization was not completed prior to the good or service being provided. A task entry that indicates failure to plan ahead and authorize for a good or service will be an audit exception. Goods or services that are determined to be an audit exception will require VR to use state funds for the cost of those goods and services. Using state funds for audit exceptions reduces the amount of state funds available for federal match.
- The authorization must identify:
- the terms and conditions of providing the goods or service;
- the dates the provider is authorized to supply the good or services;
- a description of the goods or services being authorized; and
- the amount to be paid based on VR’s cost containment guidelines, except for goods/services authorized at Medicaid rates
- For services with required standard text, the standard text is required on the authorization.
- The authorization must be sent to the provider prior to providing the goods or services so they are aware of the authorization conditions.
- The end date on an authorization may be extended to allow for services to be provided or goods received at a later date then originally authorized.
- A reason for extending the authorization date is required.
- Authorization extensions cannot increase the amount of the authorization or the service.
- A copy of the authorization with the revised end date must be printed and sent to the provider.
Closing A Case
- A case cannot be closed until all authorization end dates have been reached. This includes authorizations that have a $0 balance because of an unencumbrance.
- Authorizations that have been paid in full (original authorized amount = payment amount)
- Authorizations for supported employment services
- Replacement authorizations should not be done to pay more then the amount originally authorized. If a replacement authorization is done for a legitimate reason (i.e., change providers) it will not be considered a late authorization.
- Payment against an authorization can exceed the amount authorized for the following:
- Tax (if from another state)
- Authorization amount was in error and provider contacted VR (document in task note)
- If an invoice is received for more than the amount authorized for a reason other then those mentioned above, follow the Consumer Accountability Policy for misuse of funds or contact the provider.