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For Billing Teams

Every Chart Arrives Billing Ready

The Revenue Integrity Engine enforces required fields before submission, calculates ASA units in real time with payer specific rounding, scores claim readiness on a 0 to 100 scale, and tracks every rejection at the field level with correction workflows.

Hard Stops on Every Required Field

Tier 1 — Universal Hard Blockers

Required on every billable case regardless of type, payer, or provider role.

  1. 1Rendering Provider NPI
  2. 2Patient Date of Birth
  3. 3Anesthesia Start Timestamp
  4. 4Anesthesia End Timestamp
  5. 5Primary Diagnosis ICD 10
  6. 6Procedure CPT Code
  7. 7Anesthesia Type
  8. 8ASA Physical Status Classification
  9. 9Place of Service Code

Tier 2 — Contextual Blockers

Required when specific conditions apply.

  • Supervising Provider NPI (when CRNA is supervised)
  • Emergency Flag
  • Qualifying Circumstance Codes
  • Estimated Blood Loss (when blood products administered)
  • Regional Technique Detail
  • OB Specific Fields
  • Pediatric Weight Confirmation (patient under 12)

A claim cannot advance to Billing Ready status until every applicable field is complete.

Real Time Unit Calculation With Payer Specific Rounding

Total Units = Base Units + apply_rounding(raw_minutes, payer_rule) + Qualifying Circumstance Units

Payer Rounding Rules

  • Ceiling 15 minute
  • Ceiling 7 minute
  • Per minute

Rounding configures at the payer level. The calculation runs in real time during the case.

Modifier Derivation

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Modifiers derive automatically from provider role, supervision model, and ASA status. Derivation logic is stored for audit defensibility.

Every input to the calculation persists as a discrete auditable field.

Seven State Case Lifecycle

  1. 1Scheduled
  2. 2Clinically In Progress
  3. 3Chart Complete
  4. 4Billing Ready
  5. 5Claim Generated
  6. 6Rejected / Needs Correction
  7. 7Closed

Every stakeholder shares this language for case state.

Claim Readiness Score: 0 to 100

Each case receives a score reflecting the probability of clean first pass adjudication based on historical rejection patterns. Billing staff use the score to prioritize review; hard blockers remain the submission gate.

94

Clean — Billing Ready

Ready to submit

67

Review Required

Missing modifier

32

Blocked

Hard blocker present

Every Rejection Feeds Back at the Field Level

When a claim is denied, AIMS captures: payer reason code, affected case ID, responsible provider, the specific field flagged, and a correction workflow. This data accumulates into provider specific error patterns and payer specific rejection analytics.

999

Structural

Format errors caught before payer processing. Immediate feedback on EDI validity.

277CA

Transport

Payer confirms the claim was accepted for adjudication. Assigns a tracking number.

835

Remittance

Payment or denial with reason codes. Denial reason routed to the responsible provider.

837P Generation Through Clearinghouse

AIMS generates 837P (SV2 loop) claim files for anesthesia. Claims route through Availity or Waystar for payer connectivity.

999

Structural EDI validity

277CA

Payer accepted for adjudication

835

Remittance and adjudication result

HIPAA CompliantSOC 2 Type IIInfrastructure by AptibleData Owned by Your Organization

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