NHCX Cancel Pre-authorization

Overview

If a pre-authorization is no longer needed — the treatment plan changed, the patient requested it, or the request was made in error — you can send a pre-authorization cancellation to the payer. This submits a cancellation task referencing the original claim and intimation numbers.

Where to find it

Open the patient's NHCX page, find the workflow with the pre-authorization to cancel, and choose Cancel Pre-auth.

Form fields

• Claim Number — the claim/pre-auth number being cancelled. This is pre-filled from the workflow and is not editable.
• Intimation Number — the intimation/reference number for the pre-authorization.
• Reason Code — why the cancellation is requested. Choose from:
  • Treatment Plan Changed
  • Patient Request
  • Financial Constraints
  • Alternative Treatment
  • Duplicate Claim
  • Administrative Error
  • Other
• Description — a free-text explanation for the payer.

Common Issues

• Claim Number is disabled — this is intentional; the number is taken from the workflow you launched the cancellation from. If it is wrong, go back and choose the correct workflow.

FAQ

Q: Can I cancel a claim that is already paid? A: Cancellation is for pre-authorizations. If a claim has already been paid, use the reprocess flow instead. See Reprocess Claim.

Q: Is a reason required? A: Yes. A reason code and description are both required.

Q: When is Cancel Pre-auth available? A: While the pre-authorization — or a claim on the same case — is still awaiting the payer's decision. It stays available even after the patient is discharged, and when a claim has errored or received no response, so you can cancel the pre-authorization and proceed. Once the payer approves, queries or rejects the case, the Cancel Pre-auth action is no longer offered. Cancelling a pre-authorization is a routine step when a patient chooses to go elsewhere or wants a different treatment, so it is not blocked at discharge.