When a client's care is being paid for by an insurance company, the VA, Medicaid, or another third-party payer, you create a third-party policy by uploading the authorization document the payer sent you. Careswitch's AI extracts the key details, and Paradigm staff review the result before the policy goes live.
For background on what policies are and how they fit in, see What is a Policy?.
Before you start
You'll need:
The client (care recipient) already created in Careswitch.
The authorization document as a PDF (clear scan or original — no photos of paper if you can avoid it).
The payer already configured in your workspace (Payers → Third-Party). If the payer isn't there yet, set it up first.
Step-by-step
Go to the client's profile → Policies tab.
Click + Policy.
Choose the payer (e.g., VA, Medicaid plan, commercial insurance).
Upload the authorization PDF. Drag and drop, or click to browse.
Confirm and submit. The policy enters Processing status — Careswitch's AI starts reading the document.
What happens after you submit
Processing
Our AI is reading the document and pulling out:
Client name and identifiers.
Payer and plan.
Authorization number, referral number, policy number.
Coverage start and end dates.
Services covered and their limits (hours, visits, or dollar caps).
Diagnosis codes, where applicable.
This usually takes a minute or two. No action needed from you.
Pending
Once the AI is done, the policy moves to Pending — Paradigm staff review what was extracted to make sure nothing's off. This step is important because insurance authorizations are legally binding documents, and a wrong digit or date can cause denied claims months later.
Turnaround is typically same-day during business hours. Nothing for you to do — just wait.
Active
The policy is approved and live. You can:
Schedule shifts against the authorized services.
Watch usage track in real time against the limits.
Generate invoices and claims using the policy's authorization number and rates.
Rejected
If something didn't validate, you'll see a Rejected status with a reason. Common reasons:
Wrong client: the document is for a different person than the client you uploaded it under.
Expired document: the coverage period has already ended.
Duplicate: a policy already exists in Careswitch for this exact authorization.
Unreadable: the PDF is too low-quality, partial, or blank for the AI to extract.
Wrong payer: the payer selected doesn't match what's on the document.
Fix the underlying issue (re-scan the document, attach it to the right client, pick the right payer, etc.) and resubmit.
Renewing or replacing an authorization
When the insurance issues a new authorization (a renewal, an extension, or a replacement after a change), upload it as a new policy rather than editing the old one. Careswitch keeps the previous policy on file as inactive/archived for historical reference, while the new one takes over for any new shifts.
Tips to avoid rejections
Upload the cleanest copy you have. The original PDF from the payer beats a phone photo every time.
Make sure the client matches. Cross-check the client name and DOB on the document against the Careswitch client record before uploading.
Check for the right payer. If the document is from a managed care org under a parent plan, pick the specific MCO in Careswitch — not the parent.
Don't duplicate. Before uploading, check the client's Policies tab to see if this authorization is already on file.
If you're setting up care for a private-paying client instead, use How to create a Private-Pay Policy.