Author Topic: THERAPYNOTES  (Read 1648 times)

rdmoore2003

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THERAPYNOTES
« on: May 26, 2016, 04:29:09 PM »
Our office recently went to a new EMR/Billing program that is cloud based.  As I am still in the learning process, I have come across more than 1 issue with this program.  Apparently, the program can multiply but cannot divide. We bill $150 per unit of testing.  Our tests range from a half unit to 2 units.   For example, if I bill cpt code 96101 for 3 units at $150 per unit. The system multiplies correctly to bill $450.  Now, I cannot bill a half unit, so it goes out as 1 unit but at half the amount, which is $75.00.   This is where this program cannot divide.  So, in speaking with the support department, I have been notified that this program can be "Bill for 1 unit for every ____ spent on this service during a single session"  In the blank, the options are 15 minutes, 30 minutes, 45 minutes, 1 hour, 75 minutes, 90 minutes, or 2 hours.    The only way to get the program to recognized a "half unit = $75.00" is to set the blank area to 30 minutes.   My concern is that by doing this, it doubles the units.  So if I am billing for say 4 units (one of these units are actually half a unit with charge of $75 and not $150), it doubles the units to 8 since it is in 30 minute intervals and not 4 (hourly units).  Does this sound correct?  I do not think it does.  I have coded and billed for 13+ years and have never seen a program like this.  My concern is more on the authorizations on some insurances will not process correctly if it is billed this way, because if we have authorization for 4 units and at the 30 minute interval, it will show correct charged amount but will show 8 units and not 4 units.  PLEASE HELP!
Regina

Michele

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Re: THERAPYNOTES
« Reply #1 on: May 27, 2016, 12:10:48 PM »
The description of 96101 indicates "per hour" so it does not seem correct to bill for 4 hours with 8 in the units.  But since the description indicates "per hour" should you be billing in 1/2 hour increments?  Wouldn't you round the time?
« Last Edit: May 27, 2016, 12:13:47 PM by Michele »
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rdmoore2003

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Re: THERAPYNOTES
« Reply #2 on: May 27, 2016, 12:52:24 PM »
Michelle,

This is my dilemma.  With changing the settings to 30 minutes, the system multiplies the units.  My main concern is for authorizations.  If authorizations are for say 3 units, and if I change to 30 minutes, the system doubles the 3 units to 6 units because of the time increments.  This new system automatically sets the units, it does not give the option to manually change the units.
Regina

Michele

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Re: THERAPYNOTES
« Reply #3 on: June 01, 2016, 06:59:27 AM »
Michelle,

This is my dilemma.  With changing the settings to 30 minutes, the system multiplies the units.  My main concern is for authorizations.  If authorizations are for say 3 units, and if I change to 30 minutes, the system doubles the 3 units to 6 units because of the time increments.  This new system automatically sets the units, it does not give the option to manually change the units.

But should you be billing in 30 minutes if the description is 1 hour?  I'm thinking it should be set to 60 minutes.  Your original post says you were trying to bill a 1/2 unit.  I don't think you can bill a 1/2 unit can you?  Aren't you supposed to round it to the nearest unit?
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rdmoore2003

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Re: THERAPYNOTES
« Reply #4 on: June 03, 2016, 08:48:31 AM »
Michelle,

This is my dilemma.  With changing the settings to 30 minutes, the system multiplies the units.  My main concern is for authorizations.  If authorizations are for say 3 units, and if I change to 30 minutes, the system doubles the 3 units to 6 units because of the time increments.  This new system automatically sets the units, it does not give the option to manually change the units.

But should you be billing in 30 minutes if the description is 1 hour?  I'm thinking it should be set to 60 minutes.  Your original post says you were trying to bill a 1/2 unit.  I don't think you can bill a 1/2 unit can you?  Aren't you supposed to round it to the nearest unit?


For 1 unit = $150.00   For 1/2 unit (it is billed for 1 unit but should divide the $150) = $75.00
Regina

Michele

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Re: THERAPYNOTES
« Reply #5 on: June 06, 2016, 10:29:34 AM »
This seems to be an issue with your software.  In Lytec I can put in .5 units on any code and it will make the adjustment.  I know they told you that you need to switch to 30 minutes but that is not going to work either.

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rdmoore2003

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Re: THERAPYNOTES
« Reply #6 on: June 07, 2016, 07:39:32 AM »
Thanks Michelle for the confirmation.
Regina