Summary
The purpose of an Authorization Template is (a) to ensure consistency of data capture when documenting patient authorizations and (b) to minimize the amount of data entry required during the authorization process. Authorization templates should be set up to cover those situations that routinely require an authorization, such as reporting the results of employment physicals or drug screens to employers, or use of PHI for marketing purposes, etc.
These templates will be used to fill data fields for specific authorizations. Keep in mind, however, that you may alter the content of a specific authorization at the time it is being made; the template simply gives you a starting point.
To set up templates for various authorization types:
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From the Home Launch Pad, click the SYSTEM ADMINISTRATION tab.
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Click the Set Up Authorization Templates button.
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Click the Add button.
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Click the radio button to indicate the party that (typically) initiates this type of authorization or request for authorization.For example, if the covered entity initiates a request for authorization from the patient, click the Entity Initiated radio button. If the receiving party, such as an employer, typically requests this authorization, check the radio button next to Receiving Entity Initiated.
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Click the radio button to indicate whether this authorization permits disclosure of the information inside the covered entity only, or whether it authorizes disclosure to an external entity (i.e. third party).
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Enter the template name in the Description field.
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Enter the Effective Dateof the form.
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In the Comments box, add any comments to further identify the form or its use (e.g. "This form has been set up specifically for the Oncology department and authorizes disclosure for research purposes.")
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Click the CONTENT / PURPOSE tab and complete the fields.
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Click the radio button to indicate the type of content that this authorization authorizes: (Disclosure of Complete Medical Record, Selected Information, Psychotherapy Notes).
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If you want to populate the Content field with items from the Quick Palette, click the palette and check the items to add them to the field, then click OK.
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Enter any other [standard] content to the Content box.
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Click the down arrow to the right of the Purpose Code field and select the purpose for this type of authorization. If you select Other Purpose, click the palette icon and check one or more purposes from the list.
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Enter any other [standard] text to the Purpose Code box.
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Click the EXPIRATION / MARKETING tab and complete the fields.
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Enter the expiration date or event:
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For Expiration, enter the number of Days from Authorization that this authorization expires (such as 5 days from Authorization) OR
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If the authorization expires upon a particular event (such as the end of a research project), check the box Expiration Occurs Upon Expiration Event, and in the next box, enter the Description of the Expiration Event.
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If this template will be used to authorize disclosures for Marketing Purposes, check the related box in the MARKETING section of the window.
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If your organization will receive financial remuneration or other commercial gain for the disclosed information, check the appropriate box, then enter a description of the commercial gain in the bottom box.
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Click the AUTHORIZATION FORM STATEMENTS tab.
On this tab, you will notice that HG has entered the default text that you set up in the System Options. You may accept this text as is, or tailor it to fit the particular type of authorization for which you are setting up a template.
Click each tab in this section, and accept the text or modify as necessary.
Once a template has been used for a specific authorization, you will not be able to delete it from your database. However, you can mark the template inactive and re-create another one. -
Review all your entries, then click OK to return to the list of Standard Templates.
See Also