Why Should I Switch to An Anesthesia Specific Billing Company
Why Should I Switch to An Anesthesia Specific Billing Company
A generic medical billing company’s focus is to support all of the procedures and doctor visits that a hospital, medical center, practice, or other healthcare organization can bill for to support their client’s financial well-being.
Allowing healthcare workers the freedom to offer their services and take proper care of their patients while outsourcing this critical task to experts ensures accurate billing and, more importantly, revenue.
When talking about medical billing services, there is a significant differentiation when talking about anesthesia billing, which might get overlooked with a generic medical billing company as compared to an anesthesia-specific billing company. Despite the belief that a generic medical billing company can also handle anesthesia billing, there is a vast difference between regular medical billing and coding and anesthesia billing and coding that focus on what an anesthesiologist needs to do during a procedure or operation.
Why Are Anesthesia Billing Companies So Important?
Several billable elements should be taken into account for proper coding and billing of an anesthesia service, data that must be recorded correctly, such as:
- Level of difficulty of the procedure
- Duration of the procedure
- Modifying factors
These are “billed” with a specific anesthesia coding, which is used during the billing process to determine the total amount to charge the insurance and the patient.
It is indispensable to have an anesthesia coding specialist that ensures this information is accurate, from the time it is captured prior to the procedure to the end of the surgery. An anesthesia-focused billing company with expert medical coders transforms the notes from the anesthesiologist or CRNA to the final figure on the claim form.
Any error during the anesthesia billing process can result in a payment rejection from insurance companies or receiving an incorrect payment from the patient, which at first glance may not seem so bad, but can have more severe consequences to the bottom line if you are receiving a lot of claim denials.
From the first error or a series of constant minor errors, the anesthesiologist or service provider may be subjected to an investigation to see the reason for the billing errors. If the investigation determines that there was any malicious intent behind it, in the worst case, this may result in prosecution for billing fraud related to anesthesia.
To avoid investigations, it is necessary to hire a billing company focused on anesthesiologist services that can cope with every complexity of anesthesia services and, most importantly, to maximize eligible revenue.
What’s The Difference Between a Regular Medical Billing Company and an Anesthesia Billing Company?
We have already commented on some points in the previous section, but to understand how the whole process works and to choose the best billing solution for anesthesiologist services, we’ve outlined some significant differences to be aware of.
Anesthesiology Billing Data: When billing for anesthesia services, there are data points that are not used when billing for other medical services. Some examples are:
- ASA physical status
- Line placements
- Postoperative pain management services.
Preparing an anesthesia record: In this document, the anesthesiologist will write all relevant information regarding the patient’s case, procedures, diagnosis, anesthesia time, physical status, etc.
Base units: Base units account for both the level of complexity of the procedure and the skills and knowledge required to perform the particular anesthetic procedure. These levels are determined annually from the ASA Relative Value Guide.
Modifiers: This specifies whether the anesthesia was personally performed, medically directed, or under the supervision of an anesthesiologist.
Time units: This point is one of the most delicate. Many problems arise because adding additional 10 or 15 minutes in the beginning or at the end of the surgery to cover their time outside the administration of anesthesia, but this is a grave mistake that generic medical billing companies may overlook.
You must be very specific in noting the minutes spent administering anesthesia to the patient and the subsequent monitoring of the patient’s well-being before, during, and after surgery.
Here an anesthesia code is assigned to the surgery and the type of procedure that was determined to be the highest base units based on the documentation provided.
Consequences of Not Working with an Anesthesia-Focused Billing Company
The anesthesia billing practices and requirements must be reviewed regularly and updated in the billing process. Hence, you must first ask your medical billing company how they stay updated on regulations and best practices.
Most of the regulations, as mentioned before, are open to “small” yet big misconceptions about how to interpret the anesthesia data, which could result in a loss of revenue.
Also, you and your anesthesia billing service must be ready to answer questions from insurance payors, your patients, any anesthesia team member, or even you. The questions should be able to be answered promptly by your vendor. Delays in answers indicate an issue with anesthesia billing knowledge.
Being adequately informed also helps with negotiations since insurance companies will deny claims that are missing or have misaligned data. Payors offer contractual negotiations that may not benefit your health organization when it comes to anesthesia services; your anesthesia billing service should be able to help you negotiate smartly.
Let’s not forget fines and fraud cases. Due to inexperience, even billing mistakes may be made innocently, but the repetition of the errors could trigger an investigation into intentional fraud. Fines are usually $11,000 per fraudulent claim, plus penalty fees triple the claim amount. Going with an anesthesia billing company could prevent mistakes due to inexperience and avoid fraud charges.
How will this improve my billing performance?
The first benefit is having peace of mind that you have outsourced medical billing to a specialized anesthesia billing company. Second is that you have correct management of your anesthesia billing processes to ensure that it is favorable for you and your patients.
You can rely on anesthesia billing services like Medi-Corp, which provides anesthesia billing solutions and software. Our detailed reporting of your anesthesia billing process helps identify what prevents you from generating more revenue (denials) and detects what makes you create more to ensure your organization can receive the correct amount for your anesthesia services.
We strongly believe that the ability to maximize your revenue is directly linked to the performance of your billing team. Your billing team should run your revenue cycle processes with importance given to completeness and accuracy.