Create Anesthesia Claims Worklist
This page allows you to generate anesthesia claims from time sheet entries in completed anesthesia time sheet batches.
On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches. On the Manage Anesthesia Time Sheet Batches page, click view/edit for a batch that shows claims not yet created
Your practice must have the Anesthesia Billing feature enabled, and you must have the Anesthesia: Time Sheet Edit role.
- Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
- 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. - 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). - 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. - Click Approve All to approve all charges.
Note: If you decide not to create claims for all the charges in this batch, you can click OK for each charge (row) that you want to approve. - Click Create Claims to create claims for the charges that you approved.
The Create Anesthesia Claims Batch page reappears 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.
- Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
- 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.
- 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). - 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. - 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. - 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.
- Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
- Click the view/edit link for a completed time sheet batch (one where the Status column reads "0 of n claims created"). The Create Anesthesia Claims Worklist appears in the Task Bar.
- Review the information under the Patient column of the Create Anesthesia Claims Worklist.
Note: One patient can have multiple time sheet entries (rows) and create claim links. - Click the create claim link for the claim that you want to create. The advanced view of the Charge Entry page appears in the Workspace.
On the Charge Entry page
- Verify that the selected Rendering provider and Supervising provider are correct.
Note: The provider you select using the Supervising provider field typically appears as the rendering provider on the claim. - Scroll down to the charge information (under the "Service Type Add-Ons" heading) and verify that the CPT codes and modifiers in the Procedures field are correct.
- Verify that the codes entered in the Diagnosis codes fields are correct.
- In the box labeled Anesthesia, read the text of the note explaining how the anesthesia units for this charge were calculated.
- Scroll down to the Create Claim button and ensure that the diagnosis and procedure codes are known to your practice.
- Click Create Claim to create the claim.
- Display the Manage Anesthesia Time Sheet Batches page: On the Main Menu, click Claims. Under CHARGE ENTRY, click Anesthesia Time Sheet Batches.
- 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.
- 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.
- Scroll down to the section called Anesthesia Cases in this Batch.
- 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.
- Parent Case — Deselect the parent case and make the selection blank.
- Click Save at the bottom of the Anesthesia Cases page.
- 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.
- From the Create Anesthesia Claims Worklist, click the create claim link in the worklist to display the Charge Entry page.
- Scroll down to the bottom of the Charge Entry page, select a reason from the Reason menu.
- Click Mark Checked Time Sheet Entries As Not Requiring Charge Entry.
The anesthesia billing workflow includes four steps:
- Create the time sheet batch
- Complete time sheets for each directing provider
- Mark the time sheet and time sheet batch as complete
- Create all claims in the time sheet batch or create claims individually
You can create claims using the Create Anesthesia Claims Worklist. The worklist provides the list of all anesthesia claims that should be generated based on the services recorded in the time sheet.
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.
Patient |
Patient name and patient ID number |
---|---|
Case |
ASA and CPT surgical anesthesia codes |
Claim |
The claim number for the anesthesia claim, or the create claim link to create the claim |