Why Anesthesia Experts Can Secure a Higher Percentage of Your Anesthesia Billings
In my 26 years of exclusive experience in billing, I’ve learned that the key to successful billing lies in thorough education and training for the entire team. This includes both the anesthesia providers and the billing staff. The adage “garbage in, garbage out” highlights the necessity of a well-designed charge slip or anesthesia record, ensuring we capture all vital information to maximize your legal reimbursement. Here’s a breakdown of our billing process.
A. Certified Professional Coders (CPC) play a crucial role. Their responsibilities include:
1. Identifying therapeutic procedures, which typically yield higher reimbursements than diagnostic ones, and requesting additional documentation if necessary to enhance reimbursement.
2. Reviewing Explanation of Benefits (EOB) to investigate any denials or partial payments.
3. Vigilantly checking for any signs of fraud, as anesthesia is high on the FBI/OIG watch list.
A. Policies & Procedures
1. Training for cash inputters or electronic payment reviewers is critical. Reports suggest that 8-12% of claims are underpaid, so each EOB must be scrutinized for accuracy.
2. Persistent follow-up is vital. According to HBMA, 11% of offices give up after one attempt, and 23% stop after two attempts to collect fees. This means insurance companies can save 33% of total reimbursements by delaying payments until they receive three billing attempts from a group.
3. Anesthesia Experts engaged our corporate attorney to draft state-specific legal letters addressing common reasons for denied and partial payments.
4. Medical directors at insurance companies, often primary care doctors therefore lack expertise in anesthesia or pain management. Our former anesthesiologist directly contacts them to discuss denials or incorrect policies. This can lead to reversals of denials and future payment accuracy. This unique service, leveraging physician-to-physician communication, is available only from billing departments with a doctor on staff. Due to company policies, insurance Medical Directors will only engage in discussions with another physician.
Anesthesia Experts’ expertise and strategic approach ensure effective and maximized reimbursement for your anesthesia services. Please call us at 660-596-2224 for a complimentary collection analysis.