Why Anesthesia Experts Can Collect More Than Other Billing Companies.
Billing and collection can be one of the most confusing and stressful parts of the anesthesia procedure. We know the importance of tailoring a unique billing solution for your anesthesia department. Anesthesia Experts enables clients to maximize revenue by utilizing a specialized billing solution and collection program. The accounts receivable and office management process includes:
In the 25 years that I have been performing billing exclusively, I have discovered that the billing process’s success depends on the amount of education and training the entire time has been given. This process must involve both the anesthesia providers along with the billing employees. The old rule “junk in junk out” illustrates the importance of a correctly designed charge slip or the anesthesia record to insure we receive all of the necessary information in order to maximize your legal reimbursement. Once this is completed then here is an outline explained the rest of the billing process.
I. Coding
A. CPC coders whose job besides correctly coding the diagnoses and procedure is to also:
1. Know that therapeutic procedure have a great reimbursement than a diagnostic one so they need to identity when the provider failed to provide the correct procedure so they can request additional documentation in order to increase your reimbursement.
2. Verifies reimbursement by examining the EOB for reason of denials or partial payments and if they are correct.
3. Fraud check for any signs of fraud since anesthesia is number 2 on the FBI/OIG hit list
II. Collections
A. Policy & Procedures
1. Education of the cash imputers or reviewers for electronic payments is important because it has been reports that 8-12% of claims are underpaid so each EOB must be verified for correct payment
2. The follow up department is important because if no payments are made then the HBMA quotes 11% of offices quit after 1 attempt and 23% quit after 2 attempts of collecting their fees. This means that the insurance companies can save 33% of their total reimbursement by just delaying the payments until they have received 3 billing attempts for the group!
3. Anesthesia Experts has paid our corporate attorney to write letters quoting case law specific to your state fighting the most common reasons for denied and partial payments
4. Medical directors for insurance companies are always primary care docs, so they know little if anything concerning anesthesia or pain management. They are called directly by our former anesthesiologist to discuss denials, partial payments or incorrect policies. This is important because medical directors can reverse any denial or partial payments once they are trained on why a particular service was necessary. This education can also cause fewer incorrect payments in the future from reoccurring, by the way, only billing departments or services that have a physician on staff can offer this service because you have to be a doctor to talk with the medical directors.
To learn how Anesthesia Experts can provide your anesthesia department with innovative billing solutions, call 1-866-703-5960.