An IP authorization request summary includes three parts:

Member ID includes the member identification number, member name, date of birth/age, and gender.

Authorization Details shows all the data entered for the authorization request. Fields without data indicate that the entry was optional and the user chose not to exercise the option.

If there are User Defined Fields (UDFs) in the Authorization Details, they will appear in their associated sections, as shown in the following example.

Line Item Details includes a breakdown of items in the original request and extensions, such as date range, requested days, determination status, and stay level. The number of requested days and determined days are listed before and after the status. In the first example in this topic, Line item 1 includes Requested Days – 14; Status – Approved; Determined Days – 14. Any UDFs are included.

If the line items include UDFs, the UDFs are listed in columns on the right side of the line items, as in the following example, in which Additional Detail is a UDF.

The page includes line item determination reasons if the TruCare ProAuth administrator configures their display. Expand a line item to see the reason. Administrators can display reasons for all determination types or limit the display to specific determination types. For example, the reason for Denied determinations might appear, but not for Partially Approved determinations, as in this example for Line Item 2.