OnSTAFF 2000
ANESTHESIOLOGY CHARGE POSTING
Set Up Requirements for Anesthesiology Posting:
*Utility/Provider:
Specialty: 005
Base Time Unit: Enter a time increment, in multiples of 5 minutes, which represents the number of minutes per unit. This field will be used to divide the total posted time (determined by the /Charges/Charge <Time> and <To> field entries) to calculate the Provider Units*.
Conversion Factor
1 (or 2, 3): Enter a number. The value placed in this field will be multiplied by the Total Units* to calculate the Charge Amount*. Three different conversion factors are available. The one used in the calculation will be determined by the /Utility/Insurance <Selection(1/2/3)> field entry for the particular insurance.
*Utility/Procedure:
Base Unit 1, 2, 3: These fields have been added for anesthesiology posting. The /Utility/Insurance <Selection(1/2/3)> field entry determines which base unit will be used. Press the [F2] search key to display the following valid choices:
1 - Medicare's base unit
2 - Medi-Cal's base unit
3 - Private Carrier's base unit
*Utility/Procedure/Modifier:
Base Unit: Enter a unit value. This field entry is the Modifier Units and is used to calculate the Total Units*.
* See CALCULATION OF TOTAL UNITS AND CHARGE AMOUNT
POSTING CHARGES
When posting charges for a provider whose /Utility/Provider <Specialty> is set to anesthesiology (005), On-Staff will prompt for the following:
Panel: Enter the /Utility/Procedure <Panel Code> field entry for the charge you are posting.
Date: Enter the date of service.
Base: This field entry defaults to 0 although the actual procedure units used is the /Utility/Procedure <Base Unit 1 (or 2, 3)> field entry determined by the /Utility/Insurance <Selection(1/2/3)> field entry for the particular insurance. To override this, enter the new procedure unit(s).
Time: Enter the starting time for this procedure in the format* hhmma or hhmmp hour. Enter minutes in multiples of 5. For example, enter 0900a for 9:00am or 0645p for 6:45pm.
To: Enter the ending time for this procedure in the format* hhmma or hhmmp. Enter minutes in multiples of 5. For example, enter 1015a for 10:15am or 0645p for 6:45pm.
* The colon ( : ) will automatically display between the hour and minutes. Single digit hours (1 through 9) should be enter with a leading zero. (01 through 09).
Mod: Enter the modifier (if applicable). This field will not default to the /Utility/Procedure <Modifier R (or C, E)> field entry.
Base: This field entry defaults to the /Utility/Procedure/Modifier <Base Unit> field entry corresponding to the modifier entered in the Mod field above. To override this default, enter the new modifier base unit(s).
Qty: The quantity column is not prompted for, yet displays the Total Units* posted for each charge.
* See CALCULATION OF TOTAL UNITS AND CHARGE AMOUNT
CALCULATION OF TOTAL UNITS AND CHARGE AMOUNT
Total Units: Total Units is the sum of the Provider Units, Procedure Units, and Modifier Units.
Charge Amount: Charge Amount is calculated by multiplying the Total Units by the /Utility/Provider <Conversion Factor 1 (or 2, 3)> field entry.
Example:
1: Calculate the Provider Units. The /Utility/Provider <Base Time Unit> field entry is 15 (i.e., 15 minutes per unit) and the /Charges/Charge <Time> and <To> field entries are 8:00a and 9:30a. Divide the total posted time, 90 minutes (8:00a to 9:30a), by the <Base Time Unit> of 15, equaling 6 Provider Units.
2: Calculate the Total Units. Add the Provider Units (Example 1), the Procedure Units (the /Utility/Procedure <Base Unit 1 (or 2, 3)> field entry, determined by the /Utility/Insurance <Selection(1/2/3)> field entry) and any Modifier Units if applicable, (the /Utility/Modifier <Base Unit> field entry).
3: Calculate the Charge Amount. Multiply the Total Units (Example 2), by the /Utility/Provider <Conversion 1 (2,or 3)> field entry which is determined by the /Utility/Insurance <Selection(1/2/3)> field entry.
Where this information will print on the HCFA 1500 CLAIM FORM
Private Carriers (/Utility/Insurance <Insurance Type> other than C, 1 or D):
Box 24 G will print 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' in Box 24G.
Box 24 A
through 24 F will print the following directly below each charge:
Start time 00 00 End 00 00 Total Units* 0
(For example: Start time 08 00 End 09 30 Total Units 9)
Medicare and Medi-Medi (/Utility/Insurance <Insurance Type> C and 1)
Box 24G will print 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' in Box 24G.
NOTE: Per Medicare, the starting time, ending time, and total units are not required on the claim.
Medi-Cal (/Utility/Insurance <Insurance Type> D)
Box 19 will print the following:
Start time 00 00 End 00 00 Total Time 0000
(For example: Start time 08 00 End 09 30 Total Time 90)
Box 24G will print the total posted Provider Units*.