> For the complete documentation index, see [llms.txt](https://docs.welkinhealth.com/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.welkinhealth.com/care/billing/pre-authorization.md).

# 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.

***

## 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.

***

## 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.

***

## 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.

***

## 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.

***

## 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.

***

More Questions? Contact <csm@welkinhealth.com> or your Implementation/CSM directly.


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