There are a few different types of medical billing companies. Before you find the right anesthesia billing company, you need to determine what type of medical billing company you want to use. Here are the pros and cons of each.

Download the complete guide on selecting the right type of medical billing company for your practice.

In-House Billing

In-house billing is when all billing is handled by an internal team that you are responsible for hiring, training, and maintaining staff. While there are anesthesia providers who complete their billing in house, it is less common than other specialties.


  • Dedicated exclusively to your practice
  • Have direct access to them whenever questions arise
  • Can develop practice-specific processes
  • Can be cheaper than outsourcing at very high volumes


  • Less flexible during economic turbulence
  • Employee turnover – time to hire and train
  • Must make significant investments into people, processes, and technology
  • Lower expenses often outweighed by lower revenues
  • Fixed costs regardless of the number of cases

Regional General Medical Biller

Regional general medical billers provide billing services for a range of specialties, including anesthesiologists, and typically operate within a smaller geographic area.


  • Small enough that they can prioritize your practice


  • Don’t have anesthesia-specific expertise
  • Don’t have the systems to maximize anesthesia revenue

Regional Specialty Anesthesia Biller

This type of medical billing company has the same setup as the general medical biller but provides billing service exclusively for anesthesiologists and CRNAs.


  • Small enough that they can prioritize your practice
  • Have resources to provide ongoing educational investment for coders
  • Have anesthesia-specific expertise
  • Have anesthesia-specific billing software platforms


  • Don’t provide service across multiple specialties
  • May have difficulty ramping up for large groups

National General Medical Biller

A National general medical biller provides billing services for all types of specialties across the country.


  • Have resources to provide ongoing educational investment for coders
  • Have multi-specialty services
  • Provide value-add services


  • Don’t have anesthesia-specific software platforms
  • Billers don’t have anesthesia-specific expertise
  • Too large to prioritize your practice

National Specialty Anesthesia Biller

A national specialty biller provides billing services exclusively for anesthesiologists across the US. Supporting the anesthesia niche at a larger scale gives them a more comprehensive view of the anesthesia market.


  • Have resources to provide ongoing educational investment for their coders
  • Have anesthesia-specific expertise
  • Provide value-add services
  • Have anesthesia-specific billing software platforms


  • Don’t check every line item on claims
  • Too large to prioritize your practice

You Picked the Type of Medical Biller You Want to Work with…Now What?

Now that you have determined what type of medical biller you want to work with, you want to make sure you find the right one that can provide the services you need to support your practice. We recommend asking the following questions:

  1. How do you know how my financials are doing? Do you have reports I can access?
    • You should have insight into your practice’s financials – that means complete transparency with 24/7 access to reporting.
  2. How do you keep track of my contracted amounts to ensure I am collecting the maximum for every claim?
    • Most billers don’t have the systems or processes in place to be able to track, manage, and collect everything you are owed for each payor and facility. If they don’t have an answer for this, then they likely collect the easy 80% of payments and just leave the rest uncollected.
  3. How many years of anesthesia billing experience do your coders have?
    • Anesthesia billing is complicated and unlike other specialties – you want to make sure your biller has anesthesia-specific expertise.
  4. How do you ensure your coders are up to date on all the latest codes and regulations?
    • Anesthesia coding and regulations change all the time; if there aren’t processes in place or significant investment into ongoing education, you could run into problems.
  5. Do you provide any additional services outside of billing, coding, and collections?
    • To effectively increase revenue, you need a company that has a comprehensive understanding of your practice operations and can optimize with value-add services.

It’s More Than Just Selecting the Right Type of Medical Biller

Of course, there are a lot of components to consider when looking to find the right type of medical biller to fit the needs of your practice. You need a biller that can provide you with anesthesia-specific expertise to not only maximize revenue but optimize practice operations.

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