Finding the right anesthesia billing solutions for your practice requires a lot of consideration and research. It’s important you take the time to vet every biller you’re considering to make sure they are providing the services you need to run a successful practice. Here is everything you should look for.
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What to Look for in an Anesthesia Billing Solutions Company
Billing for anesthesia is unlike billing for any other specialty. Even the “best” general medical billing company won’t have the anesthesia-specific processes and universal anesthesia expertise that is needed to maximize revenue.
You should look for a billing company that uses AAPC-certified coding specialists and who have years working within anesthesia.
Meticulous Reconciliation Process
The dark secret of the anesthesia billing industry is that payors systemically underpay claims, and most billers don’t have the technology or systems in place to catch and correct this.
Payors don’t necessarily underpay on purpose but keeping track of the contracted amounts for every procedure and every provider in their system is a lot of data to manage. They don’t always do it well. In many cases, they pay using outdated amounts from a contract that is several years old or with another provider. The only way for a billing provider to catch this is to know exactly what to expect from every payor for every provider and flag payments when they don’t match. This is a lot of work, and hardly any billing companies do it. Instead, they just cash the checks that come in and move on.
You should look for a billing company that has a meticulous reconciliation process that looks something like the following:
- You perform anesthesia services.
- You submit your notes to your billing company.
- Certified coders translate your notes into clean claims that include the codes required based on the surgical or pain procedure performed.
- Claims are submitted to insurance companies for payment.
- Submitted claims are tracked and monitored to ensure payment is received based on contracted time frames. Line items are compared to your contract to determine what the complete payment amount should be.
- Some payment is received.
- Reconciliation. The billing team goes back to compare every line item against what is in your contract. They kick-back and resubmit the required paperwork for claims that are denied or underpaid again and again until complete payment is received.
Step 7 is key. Your billing company should be taking the additional time and energy required to collect everything you’ve earned on every claim.
The depressing math of billing is that the most profitable route for the billing companies is to take the easy way. To just collect the low-hanging fruit and move on. It costs more for them in employee time to collect that last tranche of money than they will collect in revenue.
Your billing company should provide you with reporting that allows you to:
- Easily view the financial state of the entire business or the details of a single payor or provider
- See month/month and year/year comparisons
- Compare statistics between payors or providers
- Explore critical metrics like reimbursement rates, expected cash flow, collected vs. expected, and payor mix
Reports should be available to you 24/7, 365 days a year. Although you may have regular meetings to review and discuss specifics, that shouldn’t be the only time you are able to review your data.
Comprehensive Practice Management and Consulting Services
Billing is just one piece of the anesthesia practice puzzle. You should hire a billing provider that can provide the services you need to fully support your practice. Having this complete insight into your practice operations makes it possible to maximize revenue beyond billing and collections through further optimization.
Look for a billing provider that offers:
- Contract negotiation
- Scheduling & efficiency analysis
- Business consulting
- Compliance & quality reporting
- Practice management
- Accounting, tax, & payroll
Your Anesthesia Billing Solutions Provider Should Be Your Partner
Ultimately, anesthesia billing is just one component of running a successful practice. The right billing provider will provide the services you need to keep your practice running smoothly and act as a trusted advisor – not just a vendor.
Why Fusion Anesthesia?
We have been doing anesthesia billing and only anesthesia billing for over 45 years. We have extensive expertise and provide the services you need to increase revenue without spending more time in the OR.
We truly care about our clients and do everything we can to provide them with the best customer service. When you call our office, we know exactly who you are and can assist you with any questions you have. We give you the direct cell phone numbers of our top executives so you can reach out whenever you need them.
Our complete package includes comprehensive billing and practice management services to help you optimize and ensure you’re maximizing revenue.
- Contract negotiation
- Scheduling and efficiency analysis
- Compliance and quality reporting
- Credentialing support
- Business valuation and structure
- Bookkeeping and bill paying
Want to talk to us about our comprehensive services and how we can support your practice?
Or, download the complete eBook:
How to Pick an Anesthesia Billing Provider