We have said it before, and we will say it again…and again and again: anesthesia billing is complicated. It is not a generic commodity service. Hospitals and anesthesia groups that treat it that way will get burned through a loss of revenue or, worse, running afoul of regulatory problems.
Anesthesia billing requires experience and expertise to understand the implications of the coding, claim filing, and legislation that is involved. As an anesthesiologist, it is important that you find a billing company that is as specialized as you are to ensure that you are receiving your full compensation.
Anesthesia Billing Should Be Simple
That’s right, it should be simple. Ideally, once anesthesia services are performed and notes are submitted to the billing company, a technician would quickly code the bill and send the claim to the payer. In a perfect world, the payer would receive a clean claim and pay based on their contract and everything would reconcile at the end of the month. Easy-peasy.
Ideally, all claims and payments should reconcile at the end of the month…
It turns out that the world isn’t perfect.
…but anesthesia billing is complicated and payers consistently underpay their contracted amounts.
As a result, anesthesiologists need specialized billing agencies with sophisticated processes to have a hope of collecting what they are actually owed.
Are you collecting all of your contracted revenue? How do you know?
Do you really know how to evaluate your anesthesia billing company? Most anesthesiologists don’t.
Why should you? You’re busy and as long as you get your payments at the end of the month there is no reason to complain, right? Well, maybe. Chances are good that you’re missing between 5-15% of your revenue without even realizing it.
How do we know? Because virtually all of our clients who have switched to our billing services subsequently saw a revenue increase of 5-15%. They aren’t working more hours or doing anything different… we just ensure that they are collecting their contracted rates.
Reconciliation Made Easy
How do we increase revenue for our clients without any other changes? It’s partly specialized expertise and partly good old-fashioned persistence.
We use specialized software paired with a proprietary database that includes the exact contracted rates for every procedure and every payer for every one of our clients. The software compares every line item to make sure payments are meeting that specific payer’s contracted amounts. If things don’t match, we kick it back to the payer – automatically.
Our software analyzes and compares every single line item on a claim.
The dirty secret of the billing world is that no one is doing a good job of tracking payment terms. Not the payers. Not the billers. And certainly not the providers. Why? It’s what we in the industry refer to as a “pain in the ass”. Every payer contracts slightly different rates for every procedure with virtually every provider. That makes for a HUGE matrix of possible payments. And so the payers make mistakes. A lot of them. Sometimes they overpay. Sometimes they underpay. But on average they underpay. The only way to catch this is for the billing companies to track all this information themselves.
It’s simple in concept but a huge hassle to maintain in reality because rates are constantly in flux. But it goes a long way toward increasing our client’s revenue numbers. We call it our secret nerd sauce even though we’ll tell you (and our competitors) exactly how it works. To be frank, we think everyone should be doing this, but as far as we can tell, nobody does.
If you want to know if your billing service accurately tracks contracted rates, just ask them for 6 months worth of reconciliation data. If you don’t see payments consistently being kicked back for not matching your contracted rates, then you can be pretty confident that your service isn’t tracking them. And that means you could be making more money.
Without the right tools it’s nearly impossible to efficiently check every line item the same way we do.
Anesthesia Billing with Fusion Anesthesia
We have 40 years of experience providing over 400 anesthesiologists nationwide with our billing services. This expertise and the matching processes ensure that we provide the best billing services for anesthesiologists. We understand the regulations that impact your practices, help ensure you are meeting compliance requirements, and specialize in getting that last 5-15% you are owed.
Our complete anesthesia billing process supports fair and efficient billing. Typically, the process goes as follows:
- Anesthesia services are performed.
- Records are submitted to our team either via handwritten or transcribed records or sent over directly from the EHR system (whichever is easiest for the anesthesiologist).
- Coding specialists translate records into the alphanumeric gibberish and claim forms that payers require.
- Clean claims are submitted to payers to increase the chances of getting paid correctly. Our claims are checked five times, twice by humans, once by our own automation systems, and then twice again by our clearinghouse vendor.
- Payments are collected and compared to the contracted amounts and if anything doesn’t align it is sent back to the payer for additional collection.
- Repeat until the claim is paid in full.
- Tax preparation
- Practice management
- Bill paying
- Business consulting
- Compliance services
This means you can focus on patient care, rather than worrying about paperwork.
Anesthesia services are not a commodity. Neither are anesthesia billing services.
Interested in finding out how much you could be taking home? Get an audit of your past six months billing.