Trillium Payer Authorization Calculator


VideoTrillium Authorization Calculator

A new Calculator tab has been added under Patient Histories > Authorizations > Calculator for Trillium Payer. This tool helps map authorized units or hours across the from/to dates, making sure that scheduling stays within the approved limits.

Feature Overview

  • This tool is only available for Trillium payers. If a patient does not have Trillium as the primary payer, the tab will not be visible.
  • It assists in distributing approved hours/units without exceeding the authorized amount.
  • While the calculation may not always be perfectly even, it provides a starting point to guide scheduling.
  • Print the calculation sheet to assist with creating the aide care plan scheduled days and times.
  • It does not generate schedules or aide care plans.

How to Use the Trillium Calculator

Step 1: Select Authorization Details

  1. Choose the authorized From/To dates.
  2. Select whether the authorization is based on units or hours.
  3. Enter the approved number of hours/units in the "Units Approved" field.
  4. Select the days of the week the patient will be seen:
    • Select All 7 (Monday – Sunday)
    • Select Mon – Fri
    • Custom: Check individual days as needed

Step 2: Calculate First and Last Weeks

  1. Click "Calculate First/Last Weeks" to determine the visit days for the first and last weeks.
  2. Adjust any daily hours manually by typing in the grid.
  3. Click "Re-Calculate Total Hours" until the total matches the authorized units/hours.

Step 3: Finalize and Create Authorizations

  1. Once totals match, additional fields will appear at the bottom.
  2. Enter the Authorization#.
  3. Click "Create the Authorizations" to add entries to the Authorization screen.
    • This will not work if there's an existing authorization for the date range. It must be deleted, or you can manually update the entry.
    • The system will create up to three entries:
      • One for the first week
      • One for the last week
      • One for all weeks in between
Step 4: Print the Calculations 
Print the results to use for the Aide Care Plan when entering the scheduled days and times for visits. 

Tips for Adjusting Totals

  • If the totals do not match, try adjusting the To Date by moving it back one week.
    • Example: If the authorization thru date is Tuesday 9/23/2025, try using Friday 9/19/2025 instead (if the patient is scheduled Mon – Fri).
  • Manually adjust first or last week if needed to align with total approved hours.

Posted Tuesday, February 11, 2025 by farrah@barnestorm.com
http://kb.barnestorm.biz/KnowledgebaseArticle51724.aspx