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ORM Billing Questions Rehoboth McKinley Christian Health Care Services (Meditech Client Server 5.5 SR2) Hello out there. We currently enter our ORM Surgical procedures via ITS (or RAD). We are looking to automate the billing process and from what we have determined thus far, there are two possible options: Having ALL Procedures in the ORM Procedure Dictionary pointing to the BAR Procedure Dictionary (pulling BOTH the CPT code and pricing from BAR) -or- having ORM Procedures pointing to BAR Procedures (with ONLY the pricing in BAR; with the CPT code coming from ABS). Would appreciate any words of wisdom from those of you who have already fought this battle. 1. Is anyone using the ORM Procedure Dictionary (interfacing to the BAR Procedure Dictionary) for ORM billing? a. If so, is there a one-to-one relationship between the ORM Procedure Dictionary and the BAR Procedure Dictionary (so for every surgery procedure in BAR, there is an equivalent procedure in ORM: CPT = CPT)? b. If so, is the ORM staff required to enter the exact procedure(s) performed? c. If so, does the ORM staff enter it via the Process Surgical Profile enter Actual Procedure routine or via ITS (or RAD)? d. If so, which ORM staff member is responsible for the entry (i.e., clerk, nurse, coder, etc)? e. If so, where do they obtain the information as to which procedure(s) to enter (i.e., physician-order or other form, physician-verbal, medical record, etc)? 2. Is anyone using a time-increment and/or complexity level (i.e., 15 minute increments, Minor vs. Major, etc.) method of charging rather than fee for service? a. If so, what increment measurement and/or complexity level are you using? b. If so, how was pricing determined (i.e., industry standard rates, average rates based on actual procedure performed, etc.? c. If so, how are you determining your final time value (i.e., end time less start time manually computed, computed by Meditech, rounded to nearest , converted to units, etc)? d. If so, how is the time value stored (i.e., in / by Meditech, manually on charge sheet, etc)? e. If so, how is the time value mapped to the applicable (time increment) mnemonic (i.e., 45 minute surgery = ORM Procedure Mnemonic 0.75 or 3 units, etc)? f. If so, what is the naming convention of your Mnemonics? 3. Is anyone interfacing Surgical CPT codes from ABS to BAR for ORM billing (rather than sending the CPT code from BAR to ABS and/or using the CPT from the BAR Procedure Dictionary for billing for surgical procedures)? a. If so, are you interfacing the CPT code(s) from your encoder software to ABS? b. If so, does the CPT code(s) then flow from ABS to BAR? c. If so, does the CPT code(s) display properly on the claim? d. If so, are you then using the time increment and/or complexity level method of charging (so that the CPT is coming from ABS and only a price and not the CPT is coming from the BAR Procedure Dictionary)? e. If not, what method of charging are you using? Your input is GREATLY appreciated! Jeannie Morgan, Financial Analyst Michael J. Peretti, RN, Clinical Analyst Rehoboth McKinley Christian Hospital Gallup, NM _______________________________________________ meditech-l mailing list [email protected] http://mtusers.com/mailman/listinfo/meditech-l
