BILLING
SOPS
Policies
Documentation
100

What text macro is currently required documentation for time-based billing?

.time

100

What bucket should providers route psychiatrist referrals to?

tcoleman161

100

What is the maximum number of provider inbox items permitted at the end of day?

30 items

100

How many hours does a provider have to complete and close an encounter?

72 hours

200

A provider makes a home visit to a new patient and documents 45 minutes of total time on the date of service.

99342 — new patient, 30+ minutes.

200

As the on-call provider, how quickly should a provider return calls?

30 minutes

200

What percentage of charts containing a controlled substance prescription should be routed to the oversight physician for signature?

100%

200
  1. Which Athena department should TN-based providers use when sending prescriptions?

Patient’s Home TN

300

Provider completes advanced care planning, including POLST form. What is the minimum amount of time required to bill for this service?

16 min

300

What bucket should providers route home health referrals to?

hreferrals1

300

For IMG patients being prescribed long-term opioids, how frequently must a urine drug screen be performed?

90 days

300

Which 2 screeners are required for a 70 year old patient?

PHQ-2/9, STEADI Fall Risk

400

Pt discharged from hospital Friday 3pm. What is the latest time to make initial contact?

Tuesday 3pm

400

In addition to obtaining patient contact information, when should a provider directly contact their scheduler?

No shows

400

An IMG advanced practice provider is going to prescribe opioids without directly consulting an oversight physician. What is the maximum MME for a 30 day prescription?

1200 MME

400

What text macro is currently required documentation for all opioid prescriptions?

.OpioidRx

500

A provider spends 75 minutes of total time managing a complex established home patient on the date of service.

Base code 99350. Add-on for non-Medicare payers: 99417. Medicare patients at 75 minutes: bill 99350 alone

500

A provider is sick and receives approval to change to a day of telehealth work. Who is responsible for informing patients of the change?

Provider

500

For the weeks of Christmas and New Years, how many hours of patient care must full time providers be available for?

24 hours

500

What 3 components must be on an opioid prescription in TN?

Supervising physician, ICD-10 Code, “Medically Necessary” or “Exempt”