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Intellect™

 

 

ANESTHESIOLOGY CHARGE AMOUNT CALCULATION

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The Charge Amount is calculated by multiplying the Anes Conv Factor times the total of Base Units, Time Units, and Modifier Units. If the Utility  --► Provider --► Provider <Anes Time Unit Calc> field is left blank, Intellect uses the Utility  --► Procedure --► Procedure <Charge Global> fee.

 

For example:

 

1. Time Units calculation example:  The Utility --► Provider --► Provider <Anes Time Unit Calc> field entry is 15 (i.e., 15 minutes per unit) and the Charges --► Charge <Time> and <To> field entries are 8:00am and 9:30am. Divide the total posted time, 90 minutes (8:00a to 9:30a), by the <Anes Time Unit Calc> of 15, equaling 6 Time Units.

 

2. Total Units are calculated as follows: Add the Time Units (see above), the Procedure Units (the Utility --► Procedure --► Procedure <Anes Base Unit 1 (or 2, 3)> field entry, determined by the Utility --►Insurance --►Insurance <Selection (1/2/3)> field entry), and any Utility --► Procedure --►Modifier <Modifier Unit>s, if applicable, (the Modifier <Base Unit> field entry).

 

3. The Charge Amount is calculated as follows:  Multiply the Total Units (see above), by the Utility --► Provider --► Provider <Anes Conv Factor 1 (2, or 3)> field entry, determined by the Utility --►Insurance --►Insurance <Selection (1/2/3)> field entry.

 

Information displays as indicated on the CMS 1500 Claim Form (HCFA):

 

4. Private Carriers:  (Utility --► Insurance --► Insurance <Insurance Type> other than C, 1 or D):

 

4.1 Box 24 G - Intellect completes the total posted time in minutes. For example, posting the start time of 8:00am to the ending time of 9:30am would enter '90' (90 minutes) in Box 24G.

 

4.2 Box 24 A through 24 F - Directly above each charge, Intellect completes this template:  Start time 00 00 End 00 00 Total Units 0. For example: Start time 08 00 End 09 30 Total Units 9)

 

5. Medicare and Medi-Medi:  (Insurance <Insurance Type> C and 1)

 

5.1 Box 24G - Intellect completes the total posted time in minutes. For example, Box 24G posting the start time of 8:00am to the ending time of 9:30am would  enter '90' in Box 24G

 

NOTE: Per Medicare: the Starting Time, Ending Time, and Total Units are not required on the claim.

 

6. Medi-Cal:  (Insurance <Insurance Type> D)

 

Version 9.12.01 - New option

6.1 Box 19 – Due to changes to the MediCal Anesthesia billing requirements for Box 19, effective by MediCal 11/01/2009, it is no longer necessary to print the Anesthesia Start and Stop times, and Total time. This change was added to Intellect in version 9.12.01.

 

NOTE: In Intellect versions prior to 9.12.01, Intellect completes the following:
         Start time 00 00 End 00 00 Total Time 0000
         (For example:  Start time 08 00 End 09 30 Total Time   90)

 

62. Box 24G - Intellect completes the total posted Time Units.

 

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