Time Sheet

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. Click the view/edit link for the provider's name in the list of providers at the bottom of the page. The Time Sheet page for the provider appears.  
4. Patient ID — Enter the patient's ID number. You can enter a period to access the Find patient tool. After you populate the Patient ID field, athenaOne populates the Anesthesia Case list with all anesthesia cases for that patient.
   Note: The patient lookup 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.
5. Anesthesia Case — Select the anesthesia case where the anesthesia service was provided for this entry. If the Anesthesia Case menu is empty or if the anesthesia case is not listed, select [add new] to create the new anesthesia case (see instructions below). After the case is created, it appears listed here so that you can select it. You can also select [add new] to display case input fields.
   Note: Anesthesia cases are also created using the Anesthesia Cases page.
6. Start Time and End Time — Enter the start and end time of the anesthesia service.
   Note: Time is entered in 24-hour format. Times entered are exclusive. In other words, 08:00—08:30 = 30 minutes.
7. Directing / Supervising Provider — Select the username of the directing or supervising provider.
8. Directed / Rendering Provider — Select the username of the provider who rendered the service.
   Note: If the directing or supervising provider personally performed the service, select the username of the directing provider as the Directed / Rendering Provider.
9. Applies to Concurrency? — If you want to override or exclude a service or procedure from the concurrency count, select No.
10. Override Date? — For C-section services, if the epidural dates of service differ from the C-section date of service (as may happen if the procedures occur during the midnight hours and the date changes). Select this option for the procedure with the earlier date of service. When you do, date fields appear below the Start Time and End Time fields. Complete the start date and end date fields for the epidural procedure.
11. Click the Save button to save the data in the row.  
    Note: When you save the time sheet, athenaOne recalculates the number of concurrent cases for the time sheet. The concurrency value for each service appears below the Applies to Concurrency? field.
12. Continue to enter data from the provider's paper time sheet in the same manner.
13. After all the data from the provider's paper time sheet has been entered and saved, click the button to Save as Completed.

From the Time Sheet page, you can also view a concurrency graph that shows the concurrency calculation. Concurrency calculations consider cases in all time sheets, including multiple time sheets for the same provider on the same day.

athenaOne uses the time sheet batch record and the time sheet to ensure that all services are entered for a date of service. This ensures accurate concurrency counts by athenaOne.

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.

You can click the Save & View Concurrency Graph button at any time to view a graphical representation of the provider's concurrency level.

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. Click the view/edit link next to All Providers. The Time Sheet page for the providers in the time sheet batch appears.
4. Click the Add time sheet row link. Data entry fields appear for the first row in this time sheet.
5. 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.  

6. Anesthesia Case — Select [add new]. The data entry fields appear for the new case.

Enter anesthesia case information

7. 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 menu.
   Note: To create a case containing non-time-based procedures only, select the Non-Anesthesia option located under the CPT field. You can add additional non-anesthesia procedures to the case.
8. 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.
9. 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.
   
10. 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.
    
11. Service department — Select the location where services were rendered.
12. Operating room — Select the operating room where the service was rendered.
    Note: This menu appears if you have defined operating rooms in your practice via the Operating Rooms page.
13. Hospitalization dates — Enter the from and to dates of the patient's hospitalization in MM/DD/CCYY format.
14. Referring provider — Click the Choose/view link to access the Referring Provider Lookup tool and select the provider from the directory of referring providers.
15. Surgeon — Click the Choose/view link to access the Referring Provider Lookup tool and select the surgeon from the directory of referring providers.
16. Anesthesia type — Select the type of anesthesia administered.
17. Physical status — Select the physical status of the patient.
18. Extenuating circumstances — Select any extenuating circumstances.
19. Medical direction — Select "Incomplete" if fewer than seven of the direction requirements have been met (see the field reference below for more information). Otherwise, select "Complete." The meaning of the (default) option is determined by your practice settings.
20. 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.
21. Post operative complications — Select any post operative complications that apply to this anesthesia case.
    Note: This field appears only if you created a list of the post operative complications used in your practice via the Post Operative Complications page.
22. Case review — Select this option if you plan to include this anesthesia case in a future review or study.
23. Notes — Enter any notes about this anesthesia case.
24. 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.

To add non-anesthesia procedures to this case

25. To add non-anesthesia procedure codes to this case, click the Add Non-Anesthesia Procedure to this Case link. Additional CPT and Units fields appear:
    1. CPT — Enter the procedure code for the non-anesthesia service.
    2. Units — Enter the units for the non-anesthesia service. If you leave the Units field blank, it defaults to 1 when the claim is created.
    3. Diagnoses — 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. Enter the diagnosis codes in the input fields provided.
    4. Continue to add as many non-anesthesia procedures as needed. All procedures entered in a single case will be created as separate charge lines on a single claim.
    5. Click Save at the bottom of the page to save the case.

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, on every time sheet in the batch where the anesthesia case was created.

To add non-time-based procedures to an existing case, click the Edit case link to re-open the case and make your changes or additions. Click Save when you are finished.

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.

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. Click the view/edit link for the provider's name in the list of providers at the bottom of the page. The Time Sheet page for the provider appears.  
4. From the Time Sheet page, click the Edit case link that appears just below the anesthesia case section of the time sheet entry. The Anesthesia Cases page appears.
5. Edit the case as needed.
6. Click Save. The Time Sheet page reappears, showing the saved anesthesia case information.

   Note: When a time sheet is assigned a status of Completed, the Edit case link no longer appears. To edit the anesthesia case information after the time sheet is completed, you must re-open the time sheet.
   

Note: athenaOne checks your time sheet batches for possible errors every time you save a time sheet. Time sheet exceptions appear in the Exceptions in this Time Sheet section of the page.

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 create new time sheet batch. The Time Sheet Batch page appears.
3. Enter the time sheet batch name, date of service, and directing provider.
4. Click view/edit to display the Time Sheet page.
5. Record the details of the labor epidural anesthesia for the patient as you normally would.
6. Complete the time sheet as you normally would for the C-section anesthesia service.
7. Override Date? checkbox — If the epidural dates of service differ from the C-section date of service (as may happen if the procedures occur during the midnight hours and the date changes), select the procedure with the earlier date of service. Date fields appear below the Start Time and End Time fields.
8. Complete the start date and end date fields for the epidural procedure.

Note: It is important to record the anesthesia case details in the time sheet with the same date of service as the C-section. Concurrency counts are affected by an anesthesia service for a C-section, whereas the labor epidural anesthesia services are not included in the provider's concurrency count.

9. Click Save as Completed. A warning message appears.
10. Click Yes to continue. The Time Sheet Batch page reappears.
11. When you create the claims from the completed time sheet, athenaOne will translate the details of the time sheet entry and provide a single create claim link.
12. Click the create claim link and save the charges and the resulting claim on the Charge Entry page.

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. 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 Code and Knowledge Base page in the Task Bar: On the Main Menu, click Claims. Under RESOURCES, click Code and Knowledge Base.
2. In the Task Bar, enter an anesthesia code in the Code text box (for example, 99100).
3. Click Search. A list of links appears in the Task Bar.
4. Click the link under Code Base for the information that you need.
   Information about the anesthesia code appears in the Workspace.
5. If necessary, click the code in the list.
6. Click the money icon. The Physician Reimbursement information appears.
7. Select your GPCI from the GPCI menu to view the average anesthesia time units and projected reimbursement.

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. Cick the view time sheet batch page link at the bottom of the Create Anesthesia Claims Worklist to display the Time Sheet Batch page in the Workspace.
4. Scroll down to the section called Anesthesia Cases in this Batch.
5. Click the view/edit link of the anesthesia case that you want to remove from the parent-child relationship. The Anesthesia Cases page appears in the Workspace for that anesthesia case, showing the current parent case — this is the case that appears in the Create Anesthesia Claims Worklist, opposite the create claim link for the group of entries.
6. Parent Case — Deselect the parent case and make the selection blank.
7. Click Save at the bottom of the Anesthesia Cases page.
8. Right-click anywhere in the Worklist, and select Refresh from the menu to update the Worklist.
   The Worklist now shows the time sheet entry with its own create claim link. You have successfully removed the time sheet entry from the group.
   

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.

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.

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.