Time Sheet Batch

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. Click the view/edit link for the time sheet batch where the patient's anesthesia services are recorded. The Time Sheet Batch page appears.
3. Click add new anesthesia case. The Anesthesia Cases page appears.
   
   Enter the anesthesia case information

4. Patient ID —
   • If the patient is already registered in your practice, enter the patient ID number. You can also enter a period to access the Find patient tool.
     Note: The patient lookup tool available through the time sheet returns only patient ID numbers registered in the provider's provider group. Names that appear without an ID number are not registered in the provider's provider group. You must register the patient in the provider's provider group before you can select the patient.
   • If the patient is new to your practice, enter a period to access the Find patient tool, then click register new patient to display the Patient Registration page. After you save the new registration information, click the return to timesheet link in the Task Bar. The new patient information then appears in the time sheet row.  
     
5. Procedure code — Enter the CPT surgical code in the CPT field, or enter a period to access the Procedure Lookup tool and select the code from the list. After the CPT code is entered, athenaOne returns the list of corresponding ASA codes in the ASA list.
6. ASA — Select the corresponding ASA code. An asterisk indicates a local mapping.
   Note: You can create local CPT—ASA code mappings using the Local Anesthesia Code Mappings page.
7. Non-Anesthesia — Select this option if the service or procedure is not a time-based anesthesia service. If selected, this option tells athenaOne that start and stop times and ASA codes are not needed.
   Note: To add a non-anesthesia procedure to an anesthesia case, click Add Non-Anesthesia Procedure to this Case (below the Diagnoses field). Input fields appear for you to enter the procedure code, diagnosis codes, and unit for the non-anesthesia procedure.
   
8. Diagnoses — Enter the diagnosis codes used to support medical necessity. You can type a period to search for the codes by entering an ICD-10 code, ICD-9 code, or SNOMED term.
   
9. Service department — Select the location where services were rendered.
10. Operating room — Select the operating room where the service was rendered.
    Note: This menu appears if you defined operating rooms in your practice via the Operating Rooms page.
11. Hospitalization dates — Enter the from and to dates of the patient's hospitalization in MM/DD/CCYY format.
12. Referring provider — Click the Choose/view link to access the Referring Provider Lookup tool and select the provider from the directory of referring providers.
13. Surgeon — Click the Choose/view link to access the Referring Provider Lookup tool and select the surgeon from the directory of referring providers.
14. Anesthesia type — Select the type of anesthesia administered.
15. Physical status — Select the physical status of the patient.
16. Extenuating circumstances — Select any extenuating circumstances.
17. Medical direction — Select "Incomplete" when fewer than seven of the direction requirements have been met. Otherwise, select "Complete." The meaning of the (default) option is determined by your practice settings.
18. Adverse events — Select any adverse events that occurred when service was rendered.
    Note: This field appears only if you created an adverse events code set via the Adverse Events page.
19. Post operative complications — Select any post operative complications that apply to this anesthesia case.
    Note: This field appears only if you created a post operative complications list for your practice via the Post Operative Complications page.
20. Case review — Select this option if you plan to include this anesthesia case in a future review or study.
21. Notes — Enter any notes about this anesthesia case.
22. Click Save to create the anesthesia case. The new case appears listed at the bottom of the page and in the list of anesthesia cases at the bottom of the Time Sheet Batch page.

After you create an anesthesia case, it appears listed in the Anesthesia Case menu on the Time Sheet page for every time sheet entry (i.e., every line item) with a matching patient ID and on every time sheet in the batch where the anesthesia case was created.

As you add entries to the time sheet, the Anesthesia Case menu is populated when you enter the patient ID in the Patient ID field.

For every time sheet entry, you must select an existing anesthesia case or add a new anesthesia case.

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. 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.

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.

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. Create a new time sheet batch as you normally would.
3. Click the view/edit link next to a provider's name or next to All Providers in the Time Sheets in this Batch section. The time sheet appears.
4. Patient ID column — Enter a patient ID.
5. Anesthesia Case column — Select [add new].
6. Complete the other fields as you normally would.
7. Click the Add Non-Anesthesia Procedure to this Case link. Additional fields appear.
8. Procedure Code — Enter the CPT code and the number of units in the fields provided.
   Note: If you do not enter the number of units, athenaOne defaults to one unit.
9. Click the Add Diagnosis Codes link if diagnosis codes for this procedure differ from the diagnosis codes entered for the primary code on the case.
10. Diagnoses — Enter the diagnosis codes in the input fields provided.
11. Enter diagnosis codes for this specific procedure.
    Note: If you do not enter diagnosis codes for the procedure code, athenaOne will use the diagnosis codes entered for the primary procedure code on the case.
12. Repeat the previous steps to add as many non-anesthesia procedures to the case as needed.
13. Click Save.
14. Click Save as Completed on the Time Sheet page.
15. Click Save as Completed on the Time Sheet Batch page.
16. Click the create claim link or the create all claims link.

Note: If you mark your case as Not Requiring Charge Entry (when using the create claim link), you cannot mark one of the procedures as Not Requiring Charge Entry and create the claim for the others. If you need to remove a procedure from the case, return to your anesthesia case and delete the entry for the unwanted procedure.

All procedures entered in a single case appear as separate charge lines on a single claim. Each non-anesthesia procedure code may have different diagnosis codes.

When you create an anesthesia time sheet batch, athenaOne automatically creates an All Providers view: a single time sheet that can be used to enter services for any provider in the batch. You can make time sheet entries for all the directing providers and view concurrency by patient or directing provider.

When you make updates using either the All Providers view or the individual provider time sheet, your updates automatically appear in both time sheet views.

You can use the All Providers view to assign the "Completed" status to all time sheets. When you mark an individual provider's time sheet as "Completed," the provider's name no longer appears in the Directing Providers drop-down menu using the All Providers view.

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.

An anesthesiologist may direct the anesthesia services of multiple patients at the same time. The term "concurrency" is used to describe this scenario. An anesthesiologist who manages the services of up to four Certified Registered Nurse Anesthetists (CRNAs) or Anesthesia Assistants (AAs) is called a "directing provider." An anesthesiologist who manages the services of more than four CRNAs or AAs is referred to as a supervising provider.

The directing provider typically carries a paper time sheet to record the services provided during the day or shift. This time sheet looks very different from an ordinary billing slip because it reflects multiple patients, concurrent services, and the direction or supervision of CRNAs or AAs. The time sheet is an itemized listing of all the activity of all their anesthesia cases for a day.

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.