Billing time hand off anesthesia cases

ksmcarthur

Networker
Messages
34
Location
Alliance, OH
Best answers
0
Hello group. If provider A starts an anesthesia case and leaves the case but provider B finishes the case how do we bill for this? Should we bill the surgery out under both provider under their time spent on the case or put the entire case under one of the providers? I can't find much documentation to support doing it either way. Thank you all in advance.
 

danachock

Expert
Messages
306
Location
Brainerd, MN
Best answers
0
Hi ksmcarthur,
Do you bill from EPIC? I can possibly help if this is your scenario and break it down the best I can for billing okay.
First look at the time - who spent the greatest amount of time on case (Either Anesthesia Doctor A or Anesthesia Doctor B).
Next, you have the information needed (I'm just going to give a mock scenario here for my explanation okay - NO PHI provided).
The charges fall into your work queue. You can clearly see that two different anesthesia MD's were working the same case. Provider B had more time.
If this is the scenario - you take the provider with the most time to be the Service Provider.
I am assuming charges dropped in your work queue. Unsure if you know how to fix this in your charge session (WQ) or need to just post additional charges here.
Again we are back to a fictious scenario - patient needs an appendectomy. Shift change is 5 AM.
So Surgeon A starts anesthesia for an emergent appendectomy at 450 AM and then Surgeon B steps in at 5 AM and its completed at 530 AM. Everyone wants to get paid.
Either you fix your charge session to replicate what I have or you post the first part and simply post the second portion immediately so it will bill out together.

Surgeon A
The Service Provider is Surgeon B (because they have the most time) and Bill Provider is actually Surgeon A with 10 minutes

The other part of the surgery goes again with Surgeon B as both the Service Provider and the Bill Provider with 30 minutes.
Make sure that your facility is providing RVUs based on Bill Provider and not Service Provider.

If need to post charges in Epic rather than update the charges in your WQ you need to perform this the same day so they should roll together correctly on your claim. You may also need to reach out the head of your billing department to ensure my rationale is true. That is how they have this set up. Personally, for me this has been many years (nearly 10 when we brought anesthesia coding inhouse rather than outsourcing).
Please reach out if you have questions, I'm hopeful my mock scenario covers this and my explanation.
Have a wonderful evening!
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 

ksmcarthur

Networker
Messages
34
Location
Alliance, OH
Best answers
0
Hi ksmcarthur,
Do you bill from EPIC? I can possibly help if this is your scenario and break it down the best I can for billing okay.
First look at the time - who spent the greatest amount of time on case (Either Anesthesia Doctor A or Anesthesia Doctor B).
Next, you have the information needed (I'm just going to give a mock scenario here for my explanation okay - NO PHI provided).
The charges fall into your work queue. You can clearly see that two different anesthesia MD's were working the same case. Provider B had more time.
If this is the scenario - you take the provider with the most time to be the Service Provider.
I am assuming charges dropped in your work queue. Unsure if you know how to fix this in your charge session (WQ) or need to just post additional charges here.
Again we are back to a fictious scenario - patient needs an appendectomy. Shift change is 5 AM.
So Surgeon A starts anesthesia for an emergent appendectomy at 450 AM and then Surgeon B steps in at 5 AM and its completed at 530 AM. Everyone wants to get paid.
Either you fix your charge session to replicate what I have or you post the first part and simply post the second portion immediately so it will bill out together.

Surgeon A
The Service Provider is Surgeon B (because they have the most time) and Bill Provider is actually Surgeon A with 10 minutes

The other part of the surgery goes again with Surgeon B as both the Service Provider and the Bill Provider with 30 minutes.
Make sure that your facility is providing RVUs based on Bill Provider and not Service Provider.

If need to post charges in Epic rather than update the charges in your WQ you need to perform this the same day so they should roll together correctly on your claim. You may also need to reach out the head of your billing department to ensure my rationale is true. That is how they have this set up. Personally, for me this has been many years (nearly 10 when we brought anesthesia coding inhouse rather than outsourcing).
Please reach out if you have questions, I'm hopeful my mock scenario covers this and my explanation.
Have a wonderful evening!
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
Thank you Dana! This is a great explanation. We are coding manually from a charge slip not through EPIC and we use Micro MD software.
 

Legacy79

Contributor
Messages
13
Location
Philadelphia, PA
Best answers
0
Hi ksmcarthur,
Do you bill from EPIC? I can possibly help if this is your scenario and break it down the best I can for billing okay.
First look at the time - who spent the greatest amount of time on case (Either Anesthesia Doctor A or Anesthesia Doctor B).
Next, you have the information needed (I'm just going to give a mock scenario here for my explanation okay - NO PHI provided).
The charges fall into your work queue. You can clearly see that two different anesthesia MD's were working the same case. Provider B had more time.
If this is the scenario - you take the provider with the most time to be the Service Provider.
I am assuming charges dropped in your work queue. Unsure if you know how to fix this in your charge session (WQ) or need to just post additional charges here.
Again we are back to a fictious scenario - patient needs an appendectomy. Shift change is 5 AM.
So Surgeon A starts anesthesia for an emergent appendectomy at 450 AM and then Surgeon B steps in at 5 AM and its completed at 530 AM. Everyone wants to get paid.
Either you fix your charge session to replicate what I have or you post the first part and simply post the second portion immediately so it will bill out together.

Surgeon A
The Service Provider is Surgeon B (because they have the most time) and Bill Provider is actually Surgeon A with 10 minutes

The other part of the surgery goes again with Surgeon B as both the Service Provider and the Bill Provider with 30 minutes.
Make sure that your facility is providing RVUs based on Bill Provider and not Service Provider.

If need to post charges in Epic rather than update the charges in your WQ you need to perform this the same day so they should roll together correctly on your claim. You may also need to reach out the head of your billing department to ensure my rationale is true. That is how they have this set up. Personally, for me this has been many years (nearly 10 when we brought anesthesia coding inhouse rather than outsourcing).
Please reach out if you have questions, I'm hopeful my mock scenario covers this and my explanation.
Have a wonderful evening!
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT

Hi Dana, I do use EPIC as well for billing anesthesia charges. Looks like our set up is different. I wanted to ask about your set up, the service provider field, is it the anesthesiologist who had the most minutes on the case? Then the billing provider, is it the first anesthesiologist on the case?
 
Top