Click the desired authorization you'd wish to duplicate.

Check the client has defaulted correctly.

Authorization Information
Client *
JC
Casey, Jon L
RI
Items, Renewables
TA
Allen, Tim
IA
Allison, Itzel E
AA
Antuan1, Aruba
AA
Aruba4444, Antuan
HB
Boyd, Heidelore
CC
Campbell, Chris
BC
Carehome, Ben
BC
Caudy, Ben
AC
Chase, Autumn
DC
Client, Demonstration
HC
Client, Hoosier
JC
client, joyce
JC
Client3, Joyce yetanother
KC
Cline, Kevin
AC
College, Ann
AD
Dane, Artur
JD
Demoes, Jackie
SD
Diggs, Stephanie
JD
Dixon, Jefferson L
JD
Doe, John
FE
Example, Facility
RF
Fanta, Richard
RG
Grimes, Rick
CH
Haley, Carl L
JH
Harri, Joe
BH
Harrison, Ben
MH
Herring, Malcolm V
BH
Hurrison, Bin
JH
Hutchinson, Jackson
CJ
Jones, Chris
JJ
Jones, James
CK
Kelly, Charlie
EL
Lara, Emily Marie
TM
Mejia, Trace A
DM
Miller, Donna
CM
Morris, Carolina
PP
Pablo, Petey
KP
Peterson, Karina
PP
Pumpkin, Peter
ZR
Randolph, Zachary L
ER
Renewable, Employee
ER
Renewals, Employee
WR
Runsoquick, Willie
CS
Schultz, Claude
LS
Schwartz, Landyn
JS
Smith, Jane
TS
Smith, Ted
ZT
test, zing
JT
Test2, Joyce
TT
Test2, Test1
JT
Thetford, Jeanette
TT
Travis, Tommy
MT
Tyson, Mike
DV
Vester, Derek J
DV
Vester, Dylan
BW
White, Bob
SHOW INACTIVE
Visit Type *
SOURCE
(Demo) Prototype Care
(Demo) Services related to Prototype Care
123
123
1type
1type
A&D Waiver
Aged and Disabled Waiver
Attendant
Attendant visit type with modifiers.
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN Edit
A & D Waiver Edit
Attendant Care - S5125 (UA)
A & D Waiver
Attendant Care - S5125 (UA)
Aging and Disabled Waiver Services
Attendant Test
Bug Bash (03-2024)
Bug Bash Test
This is a test visit type.
CCSP
Community Care Services Program
CCSP - T1019
Personal Support Service
David's Test Visit
David's Test Visit #1 From Scratch
Deleted Client Visit Type
Visit Type associated with a deleted client
ICWP - T2025 (U5, U1, 

Check the visit type has defaulted correctly.

Check the effective start date has defaulted correctly.

Check the effective end date has defaulted correctly.

Check the service code has defaulted correctly.

Member
Member ID
Service
Service Code
S5125 - Attendant care service /15m
Attendant care services; per 15 minutes
Only one item can be selected.
Modifiers
U7 - M/caid care lev 7 state def
Medicaid level of care 7, as defined by each state
No results, try a different code...
Diagnosis Code (ICD-10)
A00.9
Cholera, unspecified
No results, try a different code...
Referring Physician
First Name
Last Name
Identifier
Referring Physician Phones
Please provide a 10 digit phone number.
Referring Physician Addresses
No results found.
Case Manager
First Name
Last Name
Identifier
Email Addresses
Start typing to add email address.
Phone Numbers
Please provide a 10 digit phone number.

Check the modifiers have defaulted correctly.

Service
Service Code
S5125 - Attendant care service /15m
Attendant care services; per 15 minutes
Only one item can be selected.
Modifiers
U7 - M/caid care lev 7 state def
Medicaid level of care 7, as defined by each state
No results, try a different code...
Diagnosis Code (ICD-10)
A00.9
Cholera, unspecified
No results, try a different code...

If needed, check the diagnosis has defaulted correctly.

Edit Authorization
CREATE
Authorization Conflicts
No authorization conflicts found.
Authorization Information
Client *
JC
Casey, Jon L
RI
Items, Renewables
TA
Allen, Tim
IA
Allison, Itzel E
AA
Antuan1, Aruba
AA
Aruba4444, Antuan
HB
Boyd, Heidelore
CC
Campbell, Chris
BC
Carehome, Ben
BC
Caudy, Ben
AC
Chase, Autumn
DC
Client, Demonstration
HC
Client, Hoosier
JC
client, joyce
JC
Client3, Joyce yetanother
KC
Cline, Kevin
AC
College, Ann
AD
Dane, Artur
JD
Demoes, Jackie
SD
Diggs, Stephanie
JD
Dixon, Jefferson L
JD
Doe, John
FE
Example, Facility
RF
Fanta, Richard
RG
Grimes, Rick
CH
Haley, Carl L
JH
Harri, Joe
BH
Harrison, Ben
MH
Herring, Malcolm V
BH
Hurrison, Bin
JH
Hutchinson, Jackson
CJ
Jones, Chris
JJ
Jones, James
CK
Kelly, Charlie
EL
Lara, Emily Marie
TM
Mejia, Trace A
DM
Miller, Donna
CM
Morris, Carolina
PP
Pablo, Petey
KP
Peterson, Karina
PP
Pumpkin, Peter
ZR
Randolph, Zachary L
ER
Renewable, Employee
ER
Renewals, Employee
WR
Runsoquick, Willie
CS
Schultz, Claude
LS
Schwartz, Landyn
JS
Smith, Jane
TS
Smith, Ted
ZT
test, zing
JT
Test2, Joyce
TT
Test2, Test1
JT
Thetford, Jeanette
TT
Travis, Tommy
MT
Tyson, Mike
DV
Vester, Derek J
DV
Vester, Dylan
BW
White, Bob
SHOW INACTIVE
Visit Type *
SOURCE
(Demo) Prototype Care
(Demo) Services related to Prototype Care
123
123
1type
1type
A&D Waiver
Aged and Disabled Waiver
Attendant
Attendant visit type with modifiers.
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN
A & D Waiver
Attendant Care - S5125 (U7 UA) - IN Edit
A & D Waiver Edit
Attendant Care - S5125 (UA)
A & D Waiver
Attendant Care - S5125 (UA)
Aging and Disabled Waiver Services
Attendant Test
Bug Bash (03-2024)
Bug Bash Test
This is a test visit type.
CCSP
Community Care Services Program
CCSP - T1019
Personal Support Service
David's Test Visit
David's Test Visit #1 From Scratch
Deleted 

Check the name of the authorization has defaulted correctly.

Units and Billing
Placeholder
Units
Hours / Partial Units
Per Day
Unit Type
Units
Units Per Hour
Total Units *
Bill Rate
Bill Rate (Per Diem)

Confirm the new authorization has been added to the the authorizations page.

How do I duplicate authorizations?