Billing Puzzle.
Posted: Wed Sep 19, 2007 8:19 am
One of the things I love about coding is solving interesting problems. Here is one that I am currently working on.
Anesthesia billing:
All anesthesia is billed by units. A unit in this example will be 15min. So if you administer anesthesia for 60min you would need to bill for 4 units.
In addition to the time units, there are also base units. Each anesthesia code is assigned a base unit based on the difficulty of administering the anesthesia. Let's use 5 units as our base.
Some payers want to see all units (base + time) and total fee ((base + time) * unit fee) on the claim. Other payers want to see only time units, but still want to see the total fee ((base + time) * unit fee). This obviously complicates things.
Anybody have any thoughts on implementation? Here is mine.
1. Add a field for base units in the procedurecode table.
2. Add a case in FormClaimPrint.cs that is "UnitsNoBase"
3. Add a case in FormClaimPrint.cs that is "UnitsAndBase"
4. Use appropriate case fields for each payer claim form.
I appreciate any thoughts on this.
Thanks.
Anesthesia billing:
All anesthesia is billed by units. A unit in this example will be 15min. So if you administer anesthesia for 60min you would need to bill for 4 units.
In addition to the time units, there are also base units. Each anesthesia code is assigned a base unit based on the difficulty of administering the anesthesia. Let's use 5 units as our base.
Some payers want to see all units (base + time) and total fee ((base + time) * unit fee) on the claim. Other payers want to see only time units, but still want to see the total fee ((base + time) * unit fee). This obviously complicates things.
Anybody have any thoughts on implementation? Here is mine.
1. Add a field for base units in the procedurecode table.
2. Add a case in FormClaimPrint.cs that is "UnitsNoBase"
3. Add a case in FormClaimPrint.cs that is "UnitsAndBase"
4. Use appropriate case fields for each payer claim form.
I appreciate any thoughts on this.
Thanks.