Anesthesia Visit Concurrency

Concurrency occurs when an anesthesiologist is medically directing or medically supervising the work of one or more anesthesia professionals.

• The appropriate billing modifier is determined by the maximum number of cases the anesthesiologist is supervising during any single minute of the procedure.
• The Concurrency modifiers are set up in Anesthesia Time Units.
• For the system to calculate concurrency properly, ALL charges for the date of service MUST be entered.

For the Concurrency report to work, a few items must be in place:

• Admin > Anesthesia Time Units:  each setting must have the Claim Split setup and, where applicable, the Service Line Recalculation selected (determined by payer guidelines)
• Libraries > Billing Rendering Provider: Each Provider must have their credentials set.  These credentials are used to determine what type of split claim will be done, as well as, which "Provider" Modifiers will be used on the split claims.
• Each encounter must have a CPT line with a Start and End Time.  Without a start and end time, the Encounter will not be included on the Concurrency report and will not be split.
• Max Concurrency Rule: When a Provider medically directs more than one Case at a time, the Max Concurrency Rule would apply. Max Concurrency is set up in System Settings. If left blank, it defaults to no maximum.

• Admin > System Settings > Anesthesia > MAXCONCURRENCIES - ANESTHESIA MAXIMUM CONCURRENCIES
  
• If the Maximum Concurrency limit is reached, subsequent Claims enter a Finalization Hold (HFINAL) status.

• ALL charges for the date of service MUST be entered.

Concurrency Workflow

1. From Charges on the Left Side Menu, select the Anesthesia Concurrency button.

2. Enter the DOS From and To that is ready for Concurrency processing.
3. Services

• All
• Concurrencies Only
• Valid Concurrencies Only
• Invalid Concurrencies Only

4. Select other Filter Criteria to narrow your search.
5. Select Search.

• Selecting All Services above displays all services for review/auditing.
• All Invalid Concurrencies must be resolved before the process is finalized.

Services for Review/Auditing

1. Billing: Billing or Medically Directing Provider
2. CRNA or AA (Anesthesia Assistant): The Rendering Provider
3. Facility
4. Concurrencies: The total number of Procedures occurring between the start and stop times.

• Select the number link in the Concurrencies column to display all of the concurrent procedures under the thick black line.

5. Billable: The number of Concurrencies that will be used to determine the correct Concurrency Modifier.
6. Claim Split identifies how the claim will be generated

• Line means 2 lines on a single claim (anesthesiologist and CRNA).
• Claim means 2 separate claims.

7. Modifiers: Identifies the Modifiers expected to be on the Encounter after the Concurrency is finalized.

• An asterisk * identifies that the Encounter has not been finalized.

8. DOS: Date of Service
9. Start Time
10. End Time
11. Duration: Minutes
12. Encounter Number: Use Ctrl plus left click on mouse to navigate to the Encounter on a new tab.
13. Patient Number
14. Patient Name

Finalization

All Encounters with a Timed Procedure will be in a PFINAL (Pending Finalization) Encounter Status until they are finalized.

1. Once Finalized, these Encounters will be in the status Ready for Submission.

The Finalize button becomes available when:

• The Reference Batch where the Charge was entered is closed.
  
• Before Charges are finalized, close the Reference Batches and attach to a new Reference Batch to run the Concurrency.
  
• Any Encounters that are still in an open Batch will NOT finalize and will remain in a status of Pending Finalization.
• All Invalid Concurrencies have been resolved.
  
• This may require research, contact with the Provider, etc.
  
• Reasons for an Invalid Concurrency:
  
• A Provider has overlapping time on two Cases.
  
• A Provider has exceeded the allowed Maximum Concurrencies.
  

The Claims will now be Ready for Submission.

Learn More

Anesthesia Time Unit Settings

Anesthesia Visit Concurrency

Anesthesia Medically Directed Modifiers

Anesthesia Charge Entry

Anesthesia Billing Resources

Anesthesia System Setting: Military Time