Anesthesia Library

Help Guide for NextGen® Enterprise PM 8

Add or Modify an Anesthesia Library

Adding and modifying the anesthesia library enables you to modify the codes, rules, templates, and configurations used in anesthesia billing, scheduling, and clinical workflows. The Anesthesia library enables you to define rules that apply to the payers, and self-pay. Each set of rules includes the following: Medical Direction: These rules determine whether modifiers are added to charges based on the level of medical direction and whether charges will be split between Medical Directors and CRNAs. Concurrency Rules: These rules define specific parameters, such as the maximum number of concurrent procedures allowed, whether a Medical Director can perform and direct at the same time, and split-charge percentages for Medical Directors and CRNAs. Claim Options: These rules define specific claim parameters, such as whether or not surgical procedure codes are included on claims, and how claims break by rendering provider. SIM Options: These rules define parameters for specific SIM codes, such

Help Guide for NextGen® Enterprise PM 8

Anesthesia Library

The Anesthesia library is used by practices that do Anesthesia Concurrency Billing in NextGen® Enterprise PM. It is not typically used by practices using Basic Anesthesia Billing. The Anesthesia library enables you to define rules that apply to specific payers only, rules that apply to all other payers, and rules that apply to self-pay. Each set of rules may include one or more of the following: Medical Direction: These rules determine whether modifiers are added to charges based on the level of medical direction and whether charges will split between Medical Directors and CRNAs. Concurrency Rules: These rules define specific parameters, such as the maximum number of concurrent procedures allowed, whether a Medical Director can perform and direct at the same time, and split-charge percentages for Medical Directors vs CRNAs. Claim Options: These rules define specific claim parameters, such as whether or not surgical procedure codes are included on claims, and how claims break by renderi

File Maintenance Help for NextGen® Enterprise 8

Anesthesia Library

The Anesthesia library is used by practices that do Anesthesia Concurrency Billing in NextGen® Enterprise PM. It is not typically used by practices using Basic Anesthesia Billing. The Anesthesia library enables you to define rules that apply to specific payers only, rules that apply to all other payers, and rules that apply to self-pay. Each set of rules may include one or more of the following: Medical Direction: These rules determine whether modifiers are added to charges based on the level of medical direction and whether charges will split between Medical Directors and CRNAs. Concurrency Rules: These rules define specific parameters, such as the maximum number of concurrent procedures allowed, whether a Medical Director can perform and direct at the same time, and split-charge percentages for Medical Directors vs CRNAs. Claim Options: These rules define specific claim parameters, such as whether or not surgical procedure codes are included on claims, and how claims break by renderi

File Maintenance Help for NextGen® Enterprise

Add or Modify an Anesthesia Library

Adding and modifying the anesthesia library enables you to modify the codes, rules, templates, and configurations used in anesthesia billing, scheduling, and clinical workflows. The Anesthesia library enables you to define rules that apply to the payers, and self-pay. Each set of rules includes the following: Medical Direction: These rules determine whether modifiers are added to charges based on the level of medical direction and whether charges will be split between Medical Directors and CRNAs. Concurrency Rules: These rules define specific parameters, such as the maximum number of concurrent procedures allowed, whether a Medical Director can perform and direct at the same time, and split-charge percentages for Medical Directors and CRNAs. Claim Options: These rules define specific claim parameters, such as whether or not surgical procedure codes are included on claims, and how claims break by rendering provider. SIM Options: These rules define parameters for specific SIM codes, such

Help Guide for NextGen® Enterprise PM 8

Anesthesia Concurrency Billing

Anesthesia Concurrency Billing in NextGen® Enterprise PM can be setup and used by practices that must meet specific requirements on professional claims for anesthesia services that occur at the same time, or concurrently. Concurrency billing is typically used when the practice submits 837P/1500 claims for numerous anesthesia procedures that are administered in a hospital surgery department setting by Anesthesiologists and medically directed Certified Registered Nurse Anesthetists (CRNA). An Anesthesiologist can personally administer anesthesia to a patient. They can also oversee the administration of anesthesia by Certified Registered Nurse Anesthetists (CRNA) and Anesthesiologist Assistants (AA). When an anesthesiologist oversees up to four concurrent cases, it is considered "medical direction". In NextGen® Enterprise PM, an Anesthesia Concurrency Audit process is run prior to billing and creating claims. The audit looks at encounters with charges that were rendered by anesthesia prov

Help Guide for NextGen® Enterprise PM 8

Anesthesia Concurrency Billing

Anesthesia Concurrency Billing in NextGen® Enterprise PM can be setup and used by practices that must meet specific requirements on professional claims for anesthesia services that occur at the same time, or concurrently. Concurrency billing is typically used when the practice submits 837P/1500 claims for numerous anesthesia procedures that are administered in a hospital surgery department setting by Anesthesiologists and medically directed Certified Registered Nurse Anesthetists (CRNA). An Anesthesiologist can personally administer anesthesia to a patient. They can also oversee the administration of anesthesia by Certified Registered Nurse Anesthetists (CRNA) and Anesthesiologist Assistants (AA). When an anesthesiologist oversees up to four concurrent cases, it is considered "medical direction". In NextGen® Enterprise PM, an Anesthesia Concurrency Audit process is run prior to billing and creating claims. The audit looks at encounters with charges that were rendered by anesthesia prov

Anesthesia Library

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