Anesthesia Services
Prior to billing for anesthesia services, there are some special settings that need to be configured within Kareo so that the charges will be correctly calculated within the procedure line of an encounter when selecting a procedure that relates to anesthesia services.
Some of these settings relate to the contract and associated fee schedule that govern charges being billed to specific payers. These settings would normally be handled by the application administrator or other member of the business office who has the appropriate permission to set up or modify contracts and fee schedules. The remaining setting relates to the encounter screen of each user who will be submitting or approving encounters for anesthesia services; and this setting should be configured by each individual user.
To configure an existing contract and fee schedule, do the following:
1. From the Settings menu, click Contracts to open the contracts browser.
2. Locate and select the contract to open it.
3. Under the "General" tab of the contract, enter the Time Increment as defined by the contract; commonly 15 minutes.
4. If the contract is an Insurance-Specific contract - Under the "Insurance Plan" tab, check to make sure that all insurance plans that will be using the fee schedule have been added to the contract.
5. Under the "Fee Schedule" tab of the contract, do the following:
Select an anesthesia-related procedure. Note: The system determines that a procedure is anesthesia-related by the Type of Service (TOS) being set to 7-Anesthesia on the procedure code record. If you are using the Kareo-provided list of procedure codes, the TOS field has been pre-set for you. If you have added any additional anesthesia-related procedure codes to your code database, you must be sure that the TOS field of the Procedure Code record has been set to 7-Anesthesia.
Enter the standard fee per unit as defined by the contract.
Enter the Relative Value Unit ( RVU) for the procedure. The RVU is the industry standard factor used in pricing of medical services. Note that what you should be entering is the “Anesthesia Base Units” (i.e., the base units for the procedure performed without taking any time-based factors into account).
Enter the remaining fields as applicable.
Click Save on the right of the screen to save the procedure.
Repeat this step for all other anesthesia-related procedures.
6. Under the "Provider" tab, check to make sure that all providers who will be using this fee schedule have been added to the contract.
7. Under the "Locations" tab, check to make sure that all service locations that will be using this fee schedule have been added to the contract.
8. Once all changes have been made, click the Save button on the Task Button Bar.
To configure the procedures grid of the encounter screen to show the "Minutes" column, do the following:
1. From the Encounters menu, click New Encounter.
2. If the "Minutes" column does not already appear within the procedures grid, you must add this column by doing the following:
Right-click anywhere on the procedures grid to display the Customization menu.
Click on "Minutes" and drag it to the header row of the procedures grid, just before the "Units" column. Note that once set, this column will remain on the grid for all new encounters, unless manually removed by the user. (Remember, this needs to be done by each user who will be submitting or approving encounters for anesthesia services. If the user uses more than one computer to enter or approve encounters, then each computer needs to be configured to show the “Minutes” column within the encounter screen.)
Once configured correctly, when a user enters an anesthesia-related procedure code and then enters the minutes within the Procedures grid of an encounter record, the system will automatically calculate and display the correct charges.
Important Note: The above instructions assume that the contract and associated fee schedule have already been set up in the system by the application administrator or another designated member of the business office. In this topic, we only focus on how to configure an existing contract and fee schedule in order to bill for anesthesia services. For more detailed instructions on setting up contracts and fee schedules, please refer to the topics under Setting up a Practice > Contracts Setup.
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