Does In-House Anesthesia Billing Give You More Control? By: Jeanette Mini

In our experience, many anesthesia practices we’ve encountered with in-house anesthesia billing operations were born because of poor performance from an outsourced billing company. Does an in-house anesthesia billing operation truly give your practice more control over your revenue? You may think so, but let’s take a closer look. The anesthesia industry was already struggling with declining reimbursement and volume fluctuations brought on by the pandemic. Add to that staff shortages and hospitals tightening purse strings with regard to subsidies; it may no longer make financial sense.

When you look at the cost of managing an in-house anesthesia billing operation, payroll and benefits eat up the bulk of the cost. But those are not the only factors to consider when looking at the total cost to manage billing in-house. When performing an analysis, we find that the costs listed below are often overlooked or viewed as a one-time expense when they should be factored in annually:

• Cost of office space and security system for protection of PHI
• Cost of an anesthesia specific billing platform; set-up, licensing fees, etc.
• Cost of security technology and VPN to support remote work as a result of Covid
• Secure servers or a cloud subscription to house patient billing data
• Patient statements and credit card processing platform
• Hardware including computers, monitors, phones, keyboards and mice
• Office supplies (paper is expensive!)
• Investment into analytic tools to gather data your practice needs
• Storage unit fees for storage of paper in conjunction with governmental laws

The costs listed above you can actually put a dollar amount on and, in our experience, those costs typically account for 10-12% of your practices’ collections.

Now let’s look at some of the costs that are quite difficult to put a dollar amount on:

• Recruiting and training anesthesia specific staff is difficult. Most in-house anesthesia billing operations do not have additional staff to “pick-up the slack” if someone is on PTO or out sick.
• While many of our clients have an entrepreneurial spirit, you undoubtedly went to school to practice medicine. Isn’t your time best spent on seeing patients and generating revenue for your practice rather than managing office staff?
• Maintaining PCI compliance with regard to acceptance of credit card information.
• Lack of metrics in place to actually manage staff performance
• Billing staff gets paid regardless of the amount they collect

The average cost to outsource to a qualified billing partner is anywhere from 4-8% of net collections. Fusion Anesthesia Solutions client’s typically have a net collection percentage anywhere from 96% to 98% because we are incentivized to collect every dollar your practice is due since we get paid on what we collect.

Our teams and processes are structured in a specific manner so that the absence of one (or several) team members would not affect our ability to bill and collect your money. We have a multiple of staff cross-trained to step into areas needed as well as the ability to scale so our clients revenue is not affected.

Fusion Anesthesia offers an intimate boutique feel to our services with the technology and resources of a large operation. Our national footprint allows us to identify trends and denials across our entire client base with the ability to address and solve those issues at a higher level with designated provider representatives.

With client input, we have developed analytical tools via our CogitoAnalytics platform giving clients a “birds eye” view into their billing data. We offer the transparency that groups with in-house anesthesia billing operations often crave by providing clients with 24/7 access to patient and claim level detail. Client’s that have come to Fusion Anesthesia because they simply lacked the time to manage an in-house anesthesia billing operation have indicated that this transparency gives them complete peace of mind and reinforces that they made the right decision.

We also have a broader view of fair payer contract pricing. While rates cannot be shared or used in the negotiation process, our national scope and depth of knowledge benefits our clients when negotiating their payer contracts. We use both regional and national data for thoughtful negotiation whereas groups with in-house billing often settle for small annual increases.

At Fusion Anesthesia, everything we do is with the client in mind. We work with clients to develop tools and reporting that actually help with the management of their practice and improve quality of life. We arm you with data to make insightful financial decisions that affect your practice and solidify your facility relationships.