Surgical assistance patient claim processing in Medicare 011-43010160
Expand allThis page contains information about how to process accounts/invoices for assistant practitioners.
On this page:
Process surgeon and assistant claim where assistant bills patient directly
Process surgeon or assistant accounts/invoices where the surgeon bills on behalf of the assistant
Process surgeon and assistant claim where assistant bills patient directly
Table 1: This table describes how to process a patient claim for an assistant and surgeon where there is one surgeon and one assistant and the assistant bills the patient on a separate account/invoice.
|
Step |
Action |
|
1 |
Key surgeon items + Read more ... Key the items for the surgeon. |
|
2 |
Key assistant’s item + Read more ... Key the items for assistant using details on assistant’s account/invoice. Message 3-ASSIST is displayed. |
|
3 |
Key stroke + Read more ... Key AST in RSN field on assistant’s item line and press [Enter]. If the account/invoice is unpaid the assistant’s benefit is paid to the assistant. |
Process assistant claim where assistant bills patient directly and the surgeon’s account/invoice has not yet been submitted
Table 2: This table describes how to process an account/invoice for an assistant when the surgeon’s account/invoice has not yet been submitted.
|
Step |
Action |
|
1 |
Key items for assistant + Read more ... Key items. The message 7- No SURG is displayed. The item being claimed cannot be automatically assessed as there is no corresponding surgical item on history. |
|
2 |
Action warning message + Read more ... Review and apply assessing restrictions by following return messages. Return messages must be actioned. Further explanations can be viewed by placing the cursor at the beginning of the return message and pressing [F1]. |
Process surgeon or assistant accounts/invoices where the surgeon bills on behalf of the assistant
Table 3: This table describes how to process an account/invoice for an assistant where there is one surgeon and one assistant and the surgeon bills on behalf of the assistant (both on the same account/invoice).
|
Step |
Action |
|
1 |
Key items for surgeon + Read more ... Key the surgeon’s item/s. |
|
2 |
Key items for assistant + Read more ... Key the assistant’s items using details on surgeon's account/invoice. Note: ensure the assistant provider number is used for the assistant items. Message 3-ASSIST is displayed. |
|
3 |
Key stroke + Read more ... Key SRG in RSN: field on the assistance item line and press [Enter]. If the account/invoice is unpaid the assistant’s benefit is paid to the surgeon. |