MCO Authorization Requests

Go to Authorizations → MCO Requests. Click New Request. Select the patient, MCO, requested service type, and date range. Enter the procedure codes and number of units requested.

Enter the clinical justification for the requested services — this typically includes the patient's diagnosis codes (ICD-10), functional limitations, and the physician's order. Thorough justification improves approval rates.

Click Generate PDF to create a formatted prior authorization request document. Submit it to the MCO via their preferred method (portal, fax, or email). Update the request status to Submitted.

When the MCO responds, open the request and update the status to Approved or Denied. For approvals, enter the authorization number and approved units — these will pre-fill when you create the authorization record.