What Is AOR in Medical Billing and Why Is It Important?
Understand the critical role of patient authorization in medical billing. Learn how this document enables effective management of your healthcare information.
An Authorization of Release (AOR) allows patients to grant permission for their protected health information (PHI) to be shared or for a third party to act on their behalf in medical billing. This authorization facilitates administrative and financial processes within healthcare. Understanding AORs helps patients navigate their medical care and billing.
What an AOR Is
An AOR, or Authorization of Release, grants a healthcare provider, billing company, or family member authority to access and discuss a patient’s protected health information (PHI) or manage billing and insurance matters. This differs from an Assignment of Benefits (AOB), which directs insurance payments to the provider. An AOR focuses on information flow and delegated authority, while an AOB handles payment.
Acting on behalf of a patient can involve inquiring about denied claims, appealing insurance decisions, or discussing treatment specifics with insurers. The Health Insurance Portability and Accountability Act (HIPAA) mandates written authorization before disclosing PHI for reasons other than treatment, payment, or healthcare operations, protecting patient privacy.
When an AOR is Needed
Patients may be asked to sign an AOR in several scenarios for managing their medical and financial affairs. One instance is when a healthcare provider needs to appeal a denied insurance claim on the patient’s behalf. Without an AOR, the provider cannot access information or communicate with the insurer to resolve the issue.
An AOR is also needed if a patient wants a family member to discuss medical bills or health information with providers or insurers. If a patient engages a third-party billing advocacy service to manage claims, an AOR empowers them to act on the patient’s behalf. For complex cases with multiple providers, an AOR facilitates information sharing for coordinated care and billing.
Completing an AOR
Completing an AOR form ensures it is valid. The form requires the patient’s name, date of birth, and contact information. It also specifies the name and contact details of the authorized individual or entity, such as a healthcare provider, billing company, or family member, and their relationship to the patient.
The AOR defines the scope of authorization. This clarifies what information can be released, such as billing or medical records, and for what purpose, like claims processing or appeals. The form also indicates the authorization’s duration, whether for a specific event or period, and requires the patient’s signature and date. Patients should review the document to understand the permissions granted.
Submitting an AOR
Once an AOR form is completed and signed, its submission is straightforward. Patients can submit the form in various ways: in person at the provider’s office, through mail, via fax, or through a secure online portal. The submission method is often indicated on the form or can be clarified by the facility.
After submitting the AOR, patients should retain a copy for their records. This copy serves as proof of authorization and can be referenced if questions arise. Patients should also confirm receipt of the form by the intended party to ensure the authorization process has begun. Once received and processed, the authorized party can proceed with specified actions, such as making inquiries or appealing claims.
Patient Considerations for AORs
Patients should consider several aspects of AORs to protect their rights and privacy. Signing an AOR is voluntary; providers cannot condition treatment, payment, or benefits eligibility on a patient signing an authorization, except in limited circumstances.
Patients must understand the specific information being released, to whom it is disclosed, and for what duration, as an AOR does not grant unlimited access to their medical information. Patients also retain the right to revoke an AOR at any time with written notice. Understanding these aspects allows patients to make informed decisions about their PHI and maintain control over its disclosure.