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Utilization Review

How to use Utilization Review to track authorization usage, spot expiring auths, and identify overbilling.

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Written by Bridget Cashman
Updated yesterday

Utilization Review

Navigate to Billing → Utilization Review to track all active authorizations and identify which are approaching expiration by date or unit depletion.

What Utilization Review Shows

The Utilization Review screen displays a summary of each active authorization across your organization, including:

  • Client name and authorization date range

  • Payer and CPT codes covered

  • Total authorized units

  • Units used, units billed (with a claim), and units remaining

  • Days/week utilization within the filtered date range

Key Filters

  • Auth Expiration Date — Filter to authorizations expiring within a specified window. Use this to proactively identify clients who need renewal before services continue.

  • Min/Max Remaining Units — Filter by remaining unit balance. Use the maximum filter (e.g., Max: 3) to surface authorizations that are nearly depleted.

Negative Remaining Balance

A negative remaining unit balance means more units have been billed than were authorized. This will typically cause claim rejections. Review the affected claims to identify which services exceeded the authorized amount and take corrective action.

Authorization Status

Authorization status (active, replaced, expired, etc.) is set manually. Ritten does not automatically change authorization status based on dates or unit consumption. Review Utilization Review regularly to stay ahead of renewals.

Viewing Authorization Detail

Click View Associated Authorization Entry on any row to open the detail view for that authorization. From there you can see all services and claims associated with it, add or remove service associations, and create claims directly.

Tips

  • Use the Auth Expiration Date filter at the start of each week to catch upcoming renewals.

  • A negative balance on a high-volume payer is a strong signal to review recent claim rejections — the payer may have already started denying for exceeded units.

  • Auth status changes must be made manually — build a regular review into your billing workflow.

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