We have many hospitals that we partner with to provide revenue cycle management services for their anesthesiology departments (including academic) or employed medical groups. While we handle payer contract negotiations for our private practice clients, the process for hospital payer negotiations is very different, Fusion Anesthesia Solutions becomes the “best supporting actor” so to speak.
When our anesthesia revenue cycle partnership begins with a hospital, reviewing language pertaining to anesthesia services within the payer contract is one of our first orders of business. Our initial assessment almost always concludes with reimbursement for anesthesia services was stagnant or reimbursement was far below market value.
Some hospitals have Service Line leaders that are appointed to collaborate with managed care contracting executives on the specialty they represent, however, rarely do we come across a hospital that has appointed a Service Line Leader for anesthesia. That is one more area where Fusion Anesthesia Solutions can help.
We work with your contracting team to ensure:
-The anesthesia conversion factor is competitive within the market you serve
-That reimbursement for obstetrical services such as labor epidurals are addressed in the contract
-That non-time based procedures such as post-operative pain management and procedures performed outside of the typical operating/procedure rooms, such as Cath Lab, Interventional Radiology, and CT/MRI Imaging are also addressed in the contract and receive annual increases
-Provide data and insight into the types of anesthesia services performed to support the negotiation process
-Keep your team abreast of any payer related changes affecting anesthesia reimbursement
-Track expiration dates to ensure we engage in the negotiations process timely
In addition to annual payer contract negotiations, we interact with the managed care contracting team on a regular basis to report on widespread issues with a payer such as erroneous denials and underpayments.
If you’d like to learn more about a Fusion Anesthesia Solutions partnership for your hospital or employed medical group, contact sales@fusionanesthesia.com today.
By: Jeanette Mini