Authorization Process

Authorization Process

CTI Verification

Verify the Service Professional and Customer information using the CTI pop-up:
  1. CTI pops with ALL job information.
    1. View Scripting
  2. CTI pops with only SP Account Number.
    1. View Scripting
  3. CTI pops with a Sears assigned job.
    1. View Scripting
  4. CTI pops with no job information.
    1. View Scripting

Reason for Call

  1. Pre-Approval: 
    1. When the technician calls in advising that they need a travel fee, additional diagnostic time, and/or need to perform a diagnostic test.
  2. Checking Coverage: 
    1. When the technician calls in to verify if a part/failure is covered. We can utilize the Check Coverage Bot or TIMX SCM to verify.
    2. Check Coverage Procedure
  3. Receiving a Service Report: 
    1. After the assessment has been completed, the technician will call in to provide the authorizer with what failed, how it failed, what caused the failure, and the cost to repair/replace depending on who is suppling equipment.
    2. If this is one of our National Accounts, follow the specific procedures for that account (i.e., Sears, NSA, LG, etc.).
    3. Enter this information into the Authorization Note Template.
  4. Follow Up:
    1. When the technician calls in after the Service Report has already been submitted to get or give an update on the Service Job. Below are some examples of a follow up.
      1. Wrong part/equipment was ordered.
      2. Additional failures when job is not complete.
      3. Technician needs their claim adjusted.
      4. Customer’s information is needed.
      5. ETA of part order.

Capture Service Report

The Service Professional will provide the details of what was found during the diagnostic service appointment. Obtain as much information from the Service Professional as possible to ensure the best decision is reached. Use open ended questions to obtain the diagnosis.
  1. Ask to provide the age and condition of the product.
    1. If the Service Professional states that the unit is in poor condition, add additional details describing why.
    2. Only Good Condition or Poor Condition will be entered in the note. Fair, Fair to Good, or Fair to Poor should not be used.
    3. Age alone does not qualify the unit as Poor Condition.
  2. Ask what parts have failed.
    1. Ask additional probing questions to clarify if needed.
  3. Ask what the failure is with the parts.
  4. Ask what caused the failure with the parts.
  5. Ask if the issue was resolved during or as a result of the diagnosis.
  6. As what the technician’s recommendation to resolve the failure is.
    1. If Replacement is recommended, ask if the unit is repairable.
    2. If the unit is not repairable, ask them to explain why.
  7. Ask any other pertinent probing questions based on the diagnosis, and the technical knowledge of the Authorizer. 
    1. Reference the Technical Reference Guide as needed.

Entering Part Line Details

All parts must be added before creating a claim.
  1. DO NOT enter parts for Service Jobs assigned to Sears, Sears HVAC, or National Service Alliance.
  2. Verify who is supplying the part/equipment.
    1. We want the Service Professional to supply in most cases because it reduces cycle time for the customer.
    2. Use the Pricing and Labor Guide to negotiate with the Service Professional.
  3. If entering part line for refrigerant, click here.

Capture Job Costs

The Service Professional will provide a breakdown of all costs related to the Service Job in addition to the part costs.

Capture Diagnostic Costs
  1. Service Call or Diagnostic
    1. Includes trip to home and first 30 minutes
  2. Pre-Approved Additional Diagnosis
    1. Includes additional diagnostic and diagnostic tests (leak search)
  3. Pre-Approved Travel Fees
    1. Includes approval for $1 per mile in excess of a 25-mile radius
    2. Anything in excess of $1 per mile must be reviewed by an Authorization Specialist or Supervisor
    3. No travel fee is offered of the customers zip code is listed in the Service Professionals Master Coverage
  4. Pre-Approved Overtime
    1. Pre-Approved Overtime Pay is for the initial Service Call and Diagnosis only.
Capture Labor
  1. Repair Labor
    1. Hourly: hourly rate x number of hours 
    2. Flat Rate (Labor): the labor amount is always the same, but parts are separate at their entered amounts
    3. Flat Charge (Labor & Parts): all-inclusive rate for labor and parts
  2. Helper Labor
    1. Do not proactively offer, approve only if requested.
    2. Approved only in circumstances that require additional manpower.
    3. Calculated by reducing the labor by half, in effect paying the helper half of what the technician is being paid.
  3. Overtime
    1. Overtime is approved only in cases where the technician will work outside of normal business hours for an Emergency/Medical Emergency Service Job.
    2. All exceptions to this rule must be approved by an Authorization Specialist or Supervisor.
In the case of an Appliance Replacement, ask the Service Professional if they will install if needed, and if so, capture the labor to install.

Capture Other Charges
  1. Non-Covered Charges
    1. Charges for items that are not covered under the warranty.
    2. Typically occur when installing HVAC or Water Heaters.
  2. Other Charges
    1. Warranty Handling Fees
    2. Freight Charges
    3. Pick Up Fees
    4. Return Travel Fees

Review & Update Service Job Details

  1. General Information
    1. Verify correct Event Type has been selected
  2. Service Instructions
    1. Update Service Type for Pre-Authorizations
    2. Update Scheduled Service Date
    3. Review Service Contract Number
    4. Review Service Administrator field
    5. Review Special Instructions
  3. Service Information
    1. Review Sub-Status
      1. DO NOT update until the end of the call.
    2. Review Service Explanation
      1. The SP may have entered detailed information on the diagnosis and resolution recommended here.
    3. Update Technician Name if listed
    4. DO NOT update Service Provider Reference Number or Service Date
  4. Entitlements
    1. Review any Cap Limits
    2. Review Coverage
    3. If the deductible amount is $0 and the entitlement list is short, verify coverage using the check coverage bot or timx scm. It is very likely in this case that entitlements were overridden. 

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