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3 Frequently Asked Questions – Cheat Sheet for Anesthesia Billing

Question: Does it matter if I use an anesthesia specific billing company or a general medical billing company?

Answer: Yes. Here is the difference:

General medical billing companies are built to generally maximize revenue across all departments. In general, this works. However, anesthesiology has specific specialties and unique billing procedures. The generalized billing services are not optimizing billing and collections for anesthesiology, which means they are not collecting as much as they should or could be collecting. This equals a loss of revenue. In addition, generalized medical billing services risk regulatory compliance problems and allegations of fraud when coders try to handle the complex work of anesthesia billing without the specialized software or anesthesia coding skills.

Anesthesia specific billing companies give anesthesia billing their 100% focus. They are deeply experienced with every nuance, specialization and specifics of anesthesiology billing. They are expert in every anesthesiology billing situation and the relevant payor quirks. At Fusion Anesthesia, we know how to maximize your revenue by ensuring that we get every detail right. What does this mean for the anesthesiologist? Maximum collections and maximum revenue. We maintain and constantly update our databases to ensure that we format each claim so that it matches exactly how and what each payer requires – including their informal requirements. This customized claim filing by payer significantly speeds up processing.

At Fusion Anesthesia, we assist with compliance concerns and ensure that our doctors are in good standing with government and commercial payors by maintaining all documentation – that way our doctors don’t accidentally over code, and that they comply with national correct coding initiatives.

These kinds of value-added service are very hard to do across multiple specialties.

 

Did you know…After analyzing hundreds of thousands of claims, Fusion Anesthesia can prove that most anesthesia practices are collecting up to 15% less revenue than they could be.

 

Question: How do I know if my anesthesia practice is collecting less than it should be?

Answer: There are a few things you can look for to determine if your billing company is not maximizing your revenue.

Hint 1: Does your current company reconcile every payment versus the contracted rates on a line-by-line basis?

Ask your current company for the line-by-line reconciliation for the past 6 months of billing for your anesthesiology department. If it doesn’t exist or doesn’t show that a significant percentage of the claims were kicked back, then you are being short changed by your payors. Here’s why –

Its impractical to do for most general medical billing companies, but a very important part of anesthesiology billing. Most billing companies reconcile at the macro level, shrug off what appear to be minor discrepancies, and move on. The problem is, healthcare costs tend to go up rapidly. So if payors are paying based on outdated data, they will measurably underpay their contracted obligations.

Your anesthesia billing company should be cross-checking every line item of every claim to ensure that it meets the contracted rate with that specific payor. If there’s a discrepancy, it should be automatically kicked back to the payor to ensure you are receiving the contracted rate.

Hint 2: Does your current company provide customized real-time reporting?

Ask your billing company to provide you reports that show reimbursement rates, expected cash flow for the month, collected vs expected, days in accounts receivable, year-to-date revenue comparisons and provider comparisons. If they don’t have them, that means your billing company isn’t looking at them, which means they aren’t doing their job of maximizing your collections. Accurate reporting and total transparency should be critical for any billing company that you do business with.

Hint 3: Does your billing company brag about low days in accounts receivable?

We see billing companies talk about how they focus on keeping accounts receivable low. Days in accounts receivable is the average time from performing services to receiving payments. Generally speaking, lower is better. It’s obviously important to get paid promptly, but when it comes to anesthesiology billing, an accounts receivable lower than 30 days often indicates that the billing company is just accepting whatever the payors send, and writing off the rest. That’s great for the billing company, but bad for the anesthesia providers.

Maximizing revenue means looking at every line item and ensuring it meets the contracted amount for that service. It means arguing with payors to overcome bogus claims and disputes to force them to meet their obligations. If a payor tries to reject or discount a valid claim, your billing company should be fighting with them over it. That takes time.

Your billing company’s goal should be how to maximize your revenue, not keeping days in accounts receivable below an arbitrary number.

Did you know….The easiest way to determine if your anesthesia practice is collecting less than it should be is to ask Fusion Anesthesia for a no obligation 6-month billing audit. We will show you exactly where you are losing revenue, and how much extra revenue you could be collecting.

Question: Will I experience a dip in revenue when I transition to a new anesthesia billing company?

Answer: That depends on which company you are switching to. If you switch to Fusion Anesthesia, there will be no dip in revenue during the transition. If you switch to other billing companies, well, we can’t answer for them, but we hear that revenue dips are expected.

With Fusion Anesthesia, you will not see a dip in revenue during the transition. Why? We spend up to 90 days to fully execute the transition. During that time, we gather all the documents, study the payor contracts, and deeply understand the account before we take the account over. As soon as the transition occurs, we are fully ready to begin collecting revenue. This means the anesthesia practice will not experience any lapses in revenue. Actually, once we start our billing process, the clients typically see an increase in revenue by up to 15%.

 

 

Summary
3 Frequently Asked Questions – Cheat Sheet for Anesthesia Billing
Article Name
3 Frequently Asked Questions – Cheat Sheet for Anesthesia Billing
Description
This article answers some of the most frequent questions around anesthesia billing. Use this as your ultimate anesthesia billing cheat sheet.

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