Step-by-Step Guide: Determining If You Should Change Anesthesia Billing Companies
If you are reading this guide, you probably feel that something is wrong with your anesthesia billing.
It is important to trust your instincts and recognize that you need to know more about your current anesthesia billing process and how it is doing before you determine your next steps.
We will show you with this step-by-step guide how to determine if you should change your anesthesia billing company.
Step 1: Anesthesia Billing vs Medical Billing Companies
First, let’s discuss the importance of an anesthesia-focused billing company vs a generic medical billing company.
When talking about medical billing services, there is a significant difference between anesthesia billing processes vs. other medical billing processes, which might get overlooked with a generic medical billing company as compared to an anesthesia-specific billing company.
Many believe that a generic medical billing company can also handle anesthesia billing, but in fact, there is a vast difference between medical coding vs anesthesia coding that focus on what an anesthesiologist needs to do during a procedure or operation.
You can read more about the specific differences in our blog, Why Should I Switch to An Anesthesia Specific Billing Company.
Step 1 Summary: Make sure your vendor is anesthesia focused and properly coding anesthesia services.
Step 2: Evaluate Your Billing Company’s Responsiveness
When you ask for information, the billing company should respond promptly and without qualms about your request; i.e. they need to be transparent about what they are doing.
They also should take the initiative to offer an explanation of any report that they provide with so you can understand your current status regarding your anesthesia billing.
There should be no restrictions on your access to your practice’s information and analysis periods that you asked for.
You may want to ask other questions of your billing company, in our blog, Questions to Ask When Evaluating an Anesthesia Billing Company, we dive into all of the questions that you should be asking.
Step 2 Summary: Make sure that the billing company is responsive to your requests and that they don’t hold back on important metrics.
Step 3: Know Your Current Anesthesia Billing Company’s Track Record
Ensure that your current anesthesia billing company is on track. Start by asking for your last billing period’s records and analysis. Then compare this against last year’s numbers to see if you are seeing a growth trend and improvement.
When you work with an anesthesia billing expert, he or she will know what data needs to be reviewed and analyzed to understand if you are on track, as well as be up-to-date on the rules and regulations of specific anesthesia billing standards year over year.
To learn about more ways to determine if your anesthesia billing is on track, read our blog, How to Make Sure That Your Anesthesia Billing is On Track.
Step 3 Summary: Make sure that the billing company is improving each year and understands the latest rules and regulations for anesthesia billing each year.
Step 4: Ensure Anesthesia Billing Specifications are Meet
You can find out a lot of information about your billing companies’ capabilities and whether they are meeting specifications through the reports that they give you. You’ll want to analyze these capabilities by looking at the anesthesia services they provide billing vs. the services that you offer, any specialization that they have, and the amount of experience that they have.
A specialist in anesthesia billing knows the correct data to collect and record for billing, such as:
- Duration of procedure
- The difficulty level of the procedure
- Modifying factors
If you see data missing in their reports or other metrics that should be in anesthesia billing report, then you know that they may be missing key components of the anesthesia billing process.
Read more about the anesthesia billing metrics in our blog, What Distinguishes Anesthesia Billing from Other Medical Billing Services blog.
Step 4 Summary: Make sure that all the anesthesia metrics are correctly reflected in the reports you requested.
Step 5: Is Their Billing Anesthesia-Focused?
It is imperative that your billing company understand the correct anesthesia measurements that make up an anesthesia bill. This data is necessary in the anesthesia coding process.
If your anesthesia billing company is using the wrong anesthesia codes or is not using the proper anesthesia requirements, then your anesthesia billing may be off-track and needs to be re-evaluated.
Step 5 Summary: Make sure that anesthesia billing claims are not being denied due to a lack of anesthesia focus on the part of the medical billing company.
Step 6: Compare Billing Periods and Gather Insights
It’s likely that you have been with your billing company provider for several billing periods. During that time, they should have been able to adapt to your organization’s needs and grow your revenue over time.
The anesthesia billing vendor should be able to provide you with insights to see your opportunities for improvement and grow your anesthesia billing revenue in the future.
Step 6 Summary: Make sure that your billing company can provide insights into how to grow future revenue.
There are five essential factors to having a great anesthesia billing company which can be summarized below:
- Do they specialize in anesthesia billing? Anesthesia has unique billing and coding procedures, which a general billing company might not be able to follow, leading to suboptimal collections. You need an anesthesia billing company to maximize your revenue.
- Can I reach out to them for help/answers anytime? Should you inquire about aging AR or any other issues, the vendor should respond promptly. If they have limits on their responsiveness, you will not get the information when you need to make a decision.
- Do I have access to my data? You should be able to evaluate the accuracy of the anesthesia billing process at any time and know whether the billing company is maximizing your revenue collection. If the need arises, you should be able to audit and look at what the billing company has been doing with your data.
- Do they have a large amount of anesthesia claim denials? Reporting on claim denial data makes the billing process transparent and increases trust between you and the billing service provider. If you see that they have a large amount of anesthesia claim denials, then you should have concerns about them doing your anesthesia billing.
- Can this partnership help me increase my revenue? The primary goal of hiring a billing company is to help you boost collections. If the billing company does not demonstrate how they will get a higher revenue collected, consider other companies that offer better insights into what can be improved with your anesthesia billing process.
Want to change anesthesia billing companies? Check contract terms.
Be aware of the evergreen clauses associated with some billing companies. Usually, it is a two or three-year initial term with an auto-renewal on the anniversary date.
Understand the termination clause, in case you have trouble with bad performance in the future. You don’t want to risk your future revenue due to a contract that you can’t get out of.
Choosing Your Next Anesthesia Billing Vendor
When looking for a new vendor, be sure to call client references. Be aware of common reasons that cause anesthesia practices to part ways with billing companies. This includes high staff turnover rates, lack of transparency, missed charges, large amount of denied claims and poor response to AR issues.
The right anesthesia billing vendor should have excellent anesthesia billing compliance, which ensures:
- Confidence that their anesthesia billing services are accurate
- Improved revenue over time
- Elimination of constant errors
- Minimizing issues with payors / insurance companies
Pay attention to what the references are commenting on for both the positive and the negative points. Remember to review all of the points above with each new vendor before you are comfortable to switch vendors.
It is essential to pick the right anesthesia billing company to eliminate missed charges, improve collections, better your chances of retrieving AR, minimize days in AR, and improve transparency in transactions and collections.
Contracting with the wrong anesthesia billing company will result in claims denied and lost revenue because of improper and sloppy documentation for services you provide.
Medi-Corp, A National Medical Company, is a national RCM service provider specializing in anesthesia for ASCs, hospitals and pain management centers. Medi-Corp was founded in 1998 and provides a complete revenue cycle management solution, offering clients anesthesia billing services, practice management software, and consulting services.
As a National Medical company, Medi-Corp complements National Medical’s ASC billing services with anesthesia services.
To set up a consultation and get a free audit of your anesthesia billing, call us at 877-684-9114 or visit our website at https://medi-corp.com/. We ensure that your anesthesia billing gets on track and stays on track.