Set Up Medical Direction for Anesthesia Billing
On the
Anesthesia Library Payer Maintenance
window, select the
Medical Direction
tab.
Complete the
Medical Direction
settings as needed.
To save changes and close the window, select
OK
.
Medical Direction Field Descriptions
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Set Up Medical Direction for Anesthesia Billing
File Maintenance Help for NextGen® Enterprise 8
Medical Direction for Anesthesia Billing
The Medical Direction tab on the Anesthesia Library Payer Maintenance window enables you to assign concurrency modifiers and documentation modifiers required by payers that indicate the level of medical direction. The modifiers assigned to each level of concurrency (1 case, 2-4 cases, 5+ cases) determine whether charges are split between Medical Directors and CRNAs during the Anesthesia Concurrency Audit process in NextGen Enterprise PM. Non-Split Charges: Charges are not split for the level of concurrency when either of the following applies: A modifier is assigned to either the Medical Director or the CRNA, but not both. A modifier is not assigned to either the Medical Director or the CRNA. Both fields are blank. Split Charges: Charges are split for the level of concurrency when a modifier is assigned to both the Medical Director and the CRNA. Split charge calculations are based on the modifiers for each of the different levels of service. Note: Each level of Medical Direction can be
Help Guide for NextGen® Enterprise PM 8
Set Up Medical Direction for Anesthesia Billing
On the Anesthesia Library Payer Maintenance window, select the Medical Direction tab. Anesthesia Library Payer Maintenance window; Medical Direction tab Complete the Medical Direction settings as needed. To save changes and close the window, select OK. Medical Direction Field Descriptions Parent topic: Medical Direction for Anesthesia Billing
Help Guide for NextGen® Enterprise PM 8
Set Up Medical Direction for Anesthesia Billing
Setting up medical direction in anesthesia billing ensures proper supervision and compliance with regulatory standards, particularly for Medicare and other insurance billing. You can assign concurrency modifiers and documentation modifiers in the Medical Direction. In NextGen® Enterprise PM, the modifiers assigned to each level of concurrency 1 case, 2-4 cases, and 5+ cases determine whether charges are split between Medical Director and CRNA during the Anesthesia Concurrency Audit process. In File Maintenance, select Libraries, and then select Anesthesia. The Anesthesia Library Payer Maintenance window opens. In Anesthesia Library Payer Maintenance, select Medical Direction. In Medical Direction, enter the concurrency modifiers, and medical direction of 1, 2-4, and 5+ cases. Select OK. Medical Direction Field Descriptions You can set up the medical direction for anesthesia billing. Parent topic: Medical Direction for Anesthesia Billing
File Maintenance Help for NextGen® Enterprise
Set Up Medical Direction for Anesthesia Billing
Setting up medical direction in anesthesia billing ensures proper supervision and compliance with regulatory standards, particularly for Medicare and other insurance billing. You can assign concurrency modifiers and documentation modifiers in the Medical Direction. In NextGen® Enterprise PM, the modifiers assigned to each level of concurrency 1 case, 2-4 cases, and 5+ cases determine whether charges are split between Medical Director and CRNA during the Anesthesia Concurrency Audit process. In File Maintenance, select Libraries, and then select Anesthesia. The Anesthesia Library Payer Maintenance window opens. In Anesthesia Library Payer Maintenance, select Medical Direction. In Medical Direction, enter the concurrency modifiers, and medical direction of 1, 2-4, and 5+ cases. Select OK. Medical Direction Field Descriptions You can set up the medical direction for anesthesia billing. Parent topic: Add or Modify an Anesthesia Library
File Maintenance Help for NextGen® Enterprise
Set Up SIM Options for Anesthesia Billing
The SIM Options tab on the Anesthesia Library Payer Maintenance window allows override parameters to be defined for specific payers and SIM code ranges. Override options include; exempt from concurrency, minutes per unit, time units, price, and contractual adjustments. In File Maintenance, select Libraries, and then select Anesthesia. The Anesthesia Library Payer Maintenance window opens. On the Anesthesia Library Payer Maintenance window, select the SIM Options tab. Select Open Menu , and then select New. The SIM Range window opens. In the SIM and Thru SIM fields, enter the range of SIM codes, and then select OK. Define the SIM Options parameters for the SIM Range and Valid Payers. Select OK. SIM Options for Anesthesia Billing You can use the SIM options field's description while setting the anesthesia billing. Parent topic: Add or Modify an Anesthesia Library
File Maintenance Help for NextGen® Enterprise
Anesthesia Library Reports
The following Anesthesia Library reports can be generated from File Maintenance. The Report columns display information related to specific areas of setup for each library. Anesthesia Library Listing: This report includes information defined in the top section of the Anesthesia Library Maintenance window. Anesthesia with Payer Detail: This report includes information defined on the Anesthesia Library Payer Maintenance window for the Medical Direction, Concurrency Rules, and Claim Options tabs. Anesthesia with SIM Options: This report includes information defined on the Anesthesia Library Payer Maintenance window for the SIM Options tab. Generate an Anesthesia Library Report Parent topic: File Maintenance Library Reports
