Pre-Authorization

Payment pre-authorization temporarily holds funds on a patient's account prior to an encounter, ensuring sufficient coverage for expected costs. The pre-authorized amount is calculated based on the services added to the encounter before pre-authorization is triggered:

• Billing Type: Insurance — the Co-pay amount is used

• Billing Type: Self-Pay — the full service price is used

• Billing Type: Unknown / No Billing Type — treated as Self-Pay; full service price is used

Once a pre-authorization is scheduled or executed, manual invoice creation is disabled to prevent overcharging. Any further actions — such as applying a cancellation fee — must be handled through automations or manual updates by authorized users.

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Configuring Pre-Authorization Time

The timing for pre-authorization is a global environment setting configured in the Admin Portal → Payments Settings. Click Edit Config to enable or disable pre-authorization using the Active toggle and define how many hours before the encounter start time the pre-authorization should run.

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Managing Pre-Authorization in the Care Portal

When a pre-authorization is scheduled for an encounter, a notification appears when opening the encounter, showing the scheduled time and providing options to Reschedule or Cancel it.

Reschedule — specify a new number of hours before the encounter start time.

Cancel — cancels the pre-authorization for this encounter. It can be rescheduled later using the Reschedule button.

If the encounter start date changes, the pre-authorization automatically adjusts to the new time based on the environment's pre-authorization settings.

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Retry

If a pre-authorization fails, a notification is displayed. Once the cause is resolved (e.g., a patient card is added), a Retry button becomes available to re-attempt the pre-authorization.

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Pre-Authorization Automation

Automations can be configured to handle funds upon encounter completion or cancellation:

Event	Action	Description
Encounter Finalized	Charge Pre-authorization	Charges the pre-authorized funds plus any services added after pre-authorization
Encounter Cancelled	Charge Cancellation Fee	Charges the sum of cancellation fees for all services on the encounter
Encounter Cancelled	Release Pre-authorization	Releases the held funds without charging

To configure separate behaviors for cancellation, link the automation to a specific field in the encounter disposition.

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Manual Charge and Release

When a pre-authorization is active, authorized users can manually act on the held funds from the encounter in the Care Portal:

Charge — captures the payment. An invoice is generated for the current encounter cost. If services were added after pre-authorization, a single invoice is created covering two payments: the pre-authorized amount and the additional balance. If the encounter cost decreased after pre-authorization, the system charges the updated amount and automatically refunds the difference.

Release Hold — cancels the pre-authorization and releases the reserved funds back to the patient's account. After release, users can manually create invoices or reschedule the pre-authorization.

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More Questions? Contact [e-mail] or your Implementation/CSM directly.