Manage Anesthesia Time Sheet Batches

A member of the practice administrative staff creates a "time sheet batch" in athenaOne, via the Manage Anesthesia Time Sheet Batches page. A time sheet batch corresponds to a daily shift schedule for the anesthesiologists who are directing providers. Each date of service requires one or more time sheet batches.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. At the bottom of the page, click the link to create new time sheet batch. The Time Sheet Batch page appears.
   
3. Name — Enter the name of the time sheet batch.
4. Service Date — Enter the date of service for the time sheet batch.
5. Directing / Supervising providers — From the list, select the usernames of the directing providers who work concurrently to provide anesthesiology services on that day. (athenaOne automatically opens one time sheet for each provider selected.)
6. Notes — Enter any notes about the time sheet batch.
7. Click Save. The list of selected providers appears below, with links to view/edit and view concurrency graph for each directing provider's time sheet.
   Note: When the time sheet batch is saved, athenaOne opens time sheets for each directing provider in the batch.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Under the Open Time Sheet Batches heading in the Workspace, click view/edit for a batch that shows claims not yet created in the Status column. The Create Anesthesia Claims Worklist appears in the Task Bar.
   
3. Click Create all claims at the top of the Task Bar.
   The Create Anesthesia Claims Batch page appears in the Workspace.
   Note: On the Create Anesthesia Claims Batch page, you can see how units are calculated by pausing your cursor over the units (in the U column).
   
4. Insurance — Select the correct insurance, which can be an insurance package or a case policy. The default value is the patient's current primary insurance.
   Note: When you change the primary insurance, the procedure modifiers, units, and charges (which are based on anesthesia billing settings) are updated automatically. athenaOne highlights these changes in yellow.
5. OK — Check the OK box for each charge item (row) that you want to approve.
   Note: You can click Approve All to approve all charges at once.
   
6. Click Create Claims to create claims for the charges that you approved.

The Create Anesthesia Claims Batch page re-appears in the Workspace, with the new claim number and claim status under the Claim column. The Create Anesthesia Claims Worklist in the Task Bar has links to the created claims. The worklist is now organized to show claim status, so that you can work claims that are holding for front-end claim rules within the time sheet workflow.

A time sheet batch is complete when all its directing provider time sheets within the batch have been assigned a status of complete.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Click the view/edit link for the time sheet batch that is ready to be closed. The Time Sheet Batch page appears.
3. Click Save as Completed.

After the time sheet batch is marked as completed, the Status column on the Manage Anesthesia Time Sheet Batches page indicates the number of claims that should be created for that batch. For example, the message "0 of 4 claims created" indicates that the batch should produce four anesthesia claims.

Note: After all the claims in the time sheet batch are created, athenaOne resets the status of the time sheet batch to closed.

Note: We recommend saving frequently to commit changes and reduce long page-load times that may occur when saving large numbers of time sheet entries.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Click the view/edit link for the desired time sheet batch. The Time Sheet Batch page appears.
3. Add time sheet entries by completing the empty row.
4. Click Add time sheet row to add multiple blank rows.
5. Add or edit cases, as needed.
6. Click Save to save your work.  
   
   After saving new or updated time sheet entries, only the recent changes are displayed for your reference. If you save frequently, your recent changes will not include all time sheet entries. Click Show all entries to display all entries. To reset the display to show only recent entries, click Show recent entries.
   

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Click view/edit to the left of the time sheet batch number. The Time Sheet Batch page appears.

Reopen the time sheet batch

3. Click Reopen Batch.
4. Edit any batch-level information as needed, such as the providers or date of service.
5. Under the Time Sheets in this Batch header, click view/edit for the provider whose time sheets need to be updated, or click view/edit for All Providers.
6. Click Reopen Time Sheet.
7. Under the Update Time Sheet header, click Show all entries.

Update time sheet entries

8. To update an entry, under the Update Time Sheet Entry column at the far right, select the Update option to make any changes to an entry, or select the Delete option to delete the entry from the time sheet.
9. Scroll down to the bottom of the page and click Save & Update.
10. To change the provider or stop and start times, use the menus on the time sheet.

Edit case details

11. To change other details of the case, such as the physical status, service department, or diagnosis, click Edit case. The Anesthesia Cases page appears. Edit the information on this page.

Save and close the batch

12. Click Save & Update.
13. Click Save and Mark as Completed. A message appears saying that no additional changes can be made.
14. You are then prompted to save the time sheet batch.
15. Click Save as Completed.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Click view/edit to open a time sheet batch and display the Time Sheet Batch page.
3. Click view/edit to open a completed time sheet and display the Time Sheet page.
   The calculated number of concurrent cases for any given time sheet entry appears at the far right under the Concurrency column.
   
   You can click the View Concurrency Graph button to view concurrency for this time sheet.
   
   Note: Anesthesia concurrency calculations include cases that span midnight to accommodate overlapping cases in a previous or subsequent time sheet batch. The concurrency graph view shows cases in other time sheets when those time sheets contain cases that are concurrent with a case that spans midnight.
   
   The Anesthesia Case column notes the case identifier (CPT & ASA) and it includes a link to edit the individual case (Edit case).

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Click view/edit to open a completed time sheet batch.
3. Click view/edit to open a time sheet on the Time Sheet page.
4. Scroll to the bottom of the time sheet.
5. Click Reopen Time Sheet.
6. To add a new time sheet entry, use the provided blank row. As you edit the blank row, athenaOne automatically adds a new row to the time sheet. Click Add time sheet row to add multiple blank rows.
   
7. To delete existing time sheet entries, click Show all entries and select the Delete option in the Update Time Sheet Entry column. Click Save & Update or Save & View Concurrency Graph to delete marked items.
   
8. To edit existing time sheet entries, click Show all entries and select the Update option in the Update Time Sheet Entry column.
   
   Click Save & Update to display the entries to be edited.
   
   Click Save & Update to save your changes, or click Save and View Concurrency Graph to save and view the concurrency graph.
   
   Click Save & Mark as Completed to mark the time sheet complete.
   
   When adding or editing time sheet entries, click any of the Save buttons to display recent edits. The remaining time sheet entries remain hidden.
   
   Click Hide all entries to hide your recent edits. At any point, click Show all entries to show the entire list of time sheet entries.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Time sheet batch ID — Enter an ID number to search for.
3. Service date range — Enter or select a service date range for the search.
4. Created date range — Enter or select a created date range for the search.
5. Created by — Enter an athenaOne username for the search.
6. Completed date range — Enter or select a completed date range for the search.
7. Completed by — Enter an athenaOne username for the search.
8. Claims created date range — Enter or select a claims created date range.
9. Claim created by — Enter the athenaOne username of the person who created the time sheet batch claims.
10. Directing/Supervising provider — Select a directing or supervising provider.
11. Include closed batches — Select this option to include closed batches in the search.
12. Click Filter Batches. The search results appear below.
    Note: The list of batches returned is limited to those time sheet batches in which a time sheet is assigned to one of the selected directing providers.

1. Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
2. Click view/edit to select the time sheet batch that needs charges added or updated (the batch will have a completed status, such as "2 of 2 time sheets completed"). The Time Sheet Batch page appears.
3. Under the Time Sheets in this Batch heading, click view/edit to select one of the individual time sheets, or click view/edit for the All Providers view. The Time Sheet page appears.
4. Scroll to the bottom of the page and click Reopen Time Sheets.
5. Enter or edit the late charges (i.e., the additional services) into the time sheet.
• If the patient claims have not yet been completed, athenaOne automatically modifies them in the Create Anesthesia Claims Worklist.  
• If the claim has been previously created and the newly entered charges have a material effect on the previously entered charges (e.g., a change in concurrency level in which the changes in billed time have not yet been flagged to appear in the exception reporting), athenaOne highlights the claim in red in the Create Anesthesia Claims Worklist.
6. On the Time Sheet page, click Save to save the new charges, and then click Save as Completed to save the completed time sheet.
7. On the Time Sheet Batch page, click Save as Completed to complete the time sheet batch. The Create Anesthesia Claims Worklist appears in the Task Bar with the Create all claims link at the top of the worklist. Any claims that are flagged for concurrency are highlighted in red.
8. In the Create Anesthesia Claims Worklist, click the linked claim number of any red-highlighted claim to display the Claim Edit page in the Workspace.

On the Claim Edit page 

9. On the Claim Edit page, scroll to the bottom of the page and locate the box with the red message: Edits to the time sheet resulted in the following changes. You see a description of the resulting changes to the time sheet (for example, "Concurrency level changed from Multiple Direction to Supervision").
10. You now have two options:
• Click Save Claim and Clear Flag to save the claim and remove it from the Create Claim list as an exception. athenaOne removes the red highlighting from the claim on the Create Anesthesia Claims Worklist and adds the description of the resulting changes to the Claim Notes section on the Claim Edit page. The claim remains in a Hold status so that you can re-drop the claim if needed.
• Click Reload Claim from Time Sheet to re-create the claim using the new information available in the time sheet. Next, click Save Claim and Clear Flag to remove the claim from the Create Anesthesia Claims Worklist.
  Note: If a claim's charges are "Reloaded from the Time Sheet" and saved, athenaOne does not re-drop the claim. A note appears in Claim Notes describing the change that was made. The claim will remain in a Hold status, and you can manually re-drop the claim if needed.  
  
  Tip: You can quickly locate charges with concurrency issues. On the Manage Anesthesia Timesheet Batches page, under the Open Time Sheet Batches section, the Status column of the time sheet batch provides a count of claims flagged because of concurrency issues.

For anesthesia time sheet batches that have a date of service on or after October 1, 2015, you must include ICD-10 codes in the Diagnoses fields on the Anesthesia Cases page. Use the ICD-10 lookup tool to search by ICD-10 code, ICD-9 code, or SNOMED term. Also, warning messages may appear for some time sheet entries, informing you of updates that you need to make to comply with ICD-10. Review these messages and make any changes necessary to add or update ICD-10 or ICD-9 codes.

For payers that are not prepared to accept ICD-10 codes, athenaOne converts ICD-10 to ICD-9 codes only when you

• Mark a time sheet batch as complete.
• Approve the ICD-10 to ICD-9 code mappings (see ICD-10 to ICD-9 Mapping).

After you approve the ICD-10 to ICD-9 mappings, ICD-10 codes are automatically downconverted to ICD-9 when you complete a time sheet batch for a payer that requires ICD-9 codes.

If you do not approve the ICD-10 to ICD-9 mappings before the ICD-10 transition date, you will not be able to enter ICD-9 codes in anesthesia time sheets or create claim batches that require ICD-9 codes. Instead, you will need to enter ICD-9 codes manually on the Charge Entry page.

Every time a time sheet is saved, athenaOne automatically checks the time sheet for exceptions and flags the scenarios listed below. You should review any exceptions on the time sheet and make the needed corrections before marking the time sheet as completed and creating claims.

• Provider Involved in Multiple Cases: athenaOne identifies instances where a provider is reported as rendering multiple services at the same time or personally performing services while directing the services of another provider at the same time.
• Overlapping Services on Patient: athenaOne identifies instances where multiple providers were reported as working with the same patient at the same time.
• Overlapping Services in Multiple Locations: athenaOne identifies instances where a provider is reported as providing services at multiple physical locations at the same time.
• Addon Code without Main Code: athenaOne identifies instances where there is a case for an add-on service (e.g., 01968) without an adjacent case for the main service.
• Concurrency Higher than Allowed: athenaOne identifies services with a higher concurrency value than allowed to qualify for medical direction.

If an exception fires, the providers and cases involved appear under the Exceptions in this Time Sheet heading at the bottom of the Time Sheet page. Each exception is linked to the corresponding anesthesia case.

In addition, each time a time sheet batch is saved, athenaOne automatically checks for exceptions. These batch exceptions appear under the Exceptions in this Batch heading at the bottom of the Time Sheet Batch page.

You should review all exceptions to determine the correct action

athenaOne assumes that services rendered by the same provider should be reported together on the same claim when athenaOne generates claims from an anesthesia time sheet. For example, non-anesthesia cases are linked to a time-based anesthesia case performed by the same rendering provider in a parent-child relationship. On the Create Anesthesia Claims Worklist, time sheet entries that are translated together onto the same claim share the same create claim link.

On the Manage Anesthesia Time Sheet Batches page, a Pending status appears for any time sheet batch that contains cases that span midnight. The Pending status indicates that cases in a previous or subsequent time sheet batch may be concurrent with cases in this time sheet batch. You must complete the other time sheet batch before you can create a claim for a case that spans midnight.

Note: The Create Anesthesia Claims worklist in the Task Bar includes a corresponding Pending Claims section.

Claims Pending Completion of Other Time Sheet Batches section on the Time Sheet Batch page

If you have cases and claims pending completion of other time sheet batches, the Time Sheet Batch page displays a section called Claims Pending Completion of Other Time Sheet Batches. Cases and claims in this section have a duration that spans midnight into another time sheet batch.

Each case in the Claims Pending Completion of Other Time Sheet Batches section has a create batch or view/edit batch link, so that you can resolve Pending statuses.

• Click create batch to create a subsequent time sheet batch and complete it.
• Click view/edit batch to display an existing time sheet batch and complete it.

Note: When you view time sheet entries for a billing batch on the Time Sheet page, any cases that span midnight display hover text for the concurrency value to indicate that the value includes a concurrent case in another time sheet batch.