Billing Puzzle.

[fdscadmin]

One of the things I love about coding is solving interesting problems. Here is one that I am currently working on.

Anesthesia billing:

All anesthesia is billed by units. A unit in this example will be 15min. So if you administer anesthesia for 60min you would need to bill for 4 units.

In addition to the time units, there are also base units. Each anesthesia code is assigned a base unit based on the difficulty of administering the anesthesia. Let's use 5 units as our base.

Some payers want to see all units (base + time) and total fee ((base + time) * unit fee) on the claim. Other payers want to see only time units, but still want to see the total fee ((base + time) * unit fee). This obviously complicates things.

Anybody have any thoughts on implementation? Here is mine.

1. Add a field for base units in the procedurecode table.
2. Add a case in FormClaimPrint.cs that is "UnitsNoBase"
3. Add a case in FormClaimPrint.cs that is "UnitsAndBase"
4. Use appropriate case fields for each payer claim form.

I appreciate any thoughts on this.

Thanks.

[jordansparks]

So you would really want to have two separate claimforms to maintain? Wouldn't it be better to add a flag to the insplan table, and then only have one box on the claimform? The box on the claimform would look different depending on the flag in the insplan. Pretty easy to do. The insplan is one table where there is plenty of room for adding fields, and plenty of space in the user interface for adding options.

[fdscadmin]

I like that idea. I think that will also make neater code. I will give it a shot.