Use this task to create a new concurrency scheme. The configured concurrency schemes are then specified during plan configuration. Connect Back Office comes with a concurrency scheme specifically configured for Medicare. The name of this concurrency scheme is Medicare Default Scheme. The modifier and supervision rules in this concurrency scheme are based on standards published by CMS. In addition to this concurrency scheme, other concurrency schemes can be configured to facilitate the requirements of other plans. A concurrency scheme must be specified at each plan configuration. A default concurrency scheme can be set to use for all plans, and then overridden with a different concurrency scheme for any plans that do not use the default concurrency scheme.
The concurrency scheme configuration includes information collected on the following tabs:
Step | Instructions | Additional Information | ||
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1 | General Concurrency Scheme Information Tab From the Concurrency Schemes page, click Create. The Concurrency Scheme: New page opens with the General Concurrency Scheme Information tab displayed. | |||
2 | In the General section, enter the name of the scheme in the Scheme Name field. | |||
3 | Enter a description of the concurrency scheme in the Description field. | |||
4 | Click Apply. | |||
5 | In the Directing Providers section:
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6 | In the Solo Providers section:
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7 | In the Directed Providers section:
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8 | In the Other Providers section:
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9 | In the Monitored Anesthesia Care section, record the two-character modifiers for the following conditions:
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10 | Click Apply. | |||
11 | Excluded Procedure Codes Tab Click the Excluded Procedure Codes tab to add or to remove the procedures included in the concurrency scheme, but excluded from the concurrency scheme rules that detect concurrency exceptions. | |||
12 | Click on add* in the Code field to display the list of procedures, and then do one of the following:
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13 | Click on the procedure from the Code drop down list of procedures. | |||
14 | Press [Tab]. The procedure code is added to the list of excluded procedure codes. |
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15 | Click Apply. | |||
16 | Physical Status Modifiers Tab Click the Physical Status Modifiers tab to configure the physical status modifiers to appear on the claim for payers who require different modifiers than the standard unit values. | |||
17 | Enter the concurrency modifier for the applicable physical status modifier (P1 through P5) for elective and emergency cases in the:
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18 | (Optional) Check the Send Physical Status Modifiers when Units are Zero checkbox to send zero physical status modifiers when unit values are zero. |
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19 | Click Apply. | |||
20 | Click Save to save and close the page. |
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Not applicable for this topic |