Anesthesia Billing

Why Anesthesia Experts Can Collect More Than Other Billing Companies.

Streamlining billing and collections for anesthesia procedures can be intricate and demanding. We acknowledge the significance of customizing a distinct billing approach for your anesthesia department. Anesthesia Experts empowers clients to optimize their revenue through specialized billing solutions and collection initiatives. This process encompasses managing accounts receivable and office operations through the following steps:

 Coding

The role of CPC coders extends beyond accurately assigning codes to diagnoses and procedures; they are also responsible for:

1. 1. Recognizing that therapeutic procedures yield higher reimbursements than diagnostic ones, enabling them to identify instances where the correct procedure wasn’t documented and request additional details to enhance reimbursement.
   2. Verifying reimbursement accuracy by scrutinizing Explanation of Benefits (EOB) statements for denials or partial payments and rectifying any discrepancies.
   3. Conducting fraud checks to detect potential fraudulent activities, given that anesthesia ranks second on the FBI/OIG watchlist.

Policies & Procedures

1. 1. Educating cash processors or reviewers of electronic payments is crucial, as reports indicate that 8-12% of claims receive inadequate payments. Consequently, each EOB must be meticulously verified for accuracy of payment.
   2. The follow-up department plays a pivotal role. The Healthcare Business Management Association (HBMA) reports that 11% of practices cease collections efforts after one attempt, and 23% after two attempts. Thus, insurance companies can delay payments until they’ve received three collection attempts, potentially saving 33% of their overall reimbursement.
   3. Anesthesia Experts has engaged our corporate attorney to draft letters citing case law specific to your state to challenge common reasons for denials and partial payments.

1. Our former anesthesiologist actively communicates with medical directors at insurance companies, who are often primary care doctors with limited expertise in anesthesia or pain management. This communication is essential for resolving issues like claim denials, partial reimbursements, or inaccurate policies. By explaining the reasoning behind specific services, the anesthesiologist can persuade medical directors to overturn these decisions. This not only addresses current payment errors but also helps prevent future ones. Importantly, this level of interaction is only possible in billing departments or services that have a physician on their team, as it requires a physician’s involvement to effectively communicate with medical directors.

 

To learn how Anesthesia Experts can provide your anesthesia department with innovative billing solutions, call 660-596-2224.