Results Driven Anesthesia Billing Company
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Overview of
Anesthesia Billing Services
Anesthesiology is one of the most difficult medical specialties. First, it can take 12-15 years of higher education for a person to become a licensed and certified anesthesiologist. Second, all the anesthesia procedures are life-threatening, leaving very little room for error. After spending hours in a stressful work environment, anesthesiologists hardly have the strength to focus on paperwork for reimbursements.
It is exactly when outsourced anesthesia billing services swoop in to save the day! From maintaining patient records to verifying insurance coverages and clean claim submission to denial management services, all the processes optimize an anesthesia practice’s revenue cycle.
Best Practices for Anesthesia Billing
Sure, anesthesia medical billing is not an easy feat. It requires accuracy, precision, dedication, and technical knowledge. Every detail before, during, and after the anesthetic administration must be translated into numerical or alphanumerical codes for rightful reimbursements. Now, that can be a tough nut to crack, especially if you don’t know what you are doing.
However, implementing best practices like adherence to Medicare’s concurrency rules, using time-based charge calculations, regulatory compliance, staff training, reporting modifiers, timely claim submission, and regular audits can help you avoid anesthesia billing pitfalls.
Use Base and Time Units
Base and Time Units are essential for the calculation of anesthesia charges. The Centers for Medicare and Medicaid Services (CMS) assign these values specific to each anesthesia CPT code. These units denote the time an anesthesiologist spends before and during surgery.
Follow Medicare’s Concurrency Rules
When administering anesthesia to multiple patients with Medicare coverage, the anesthesia billing specialist must follow the concurrency rules. For example, the rule states that three base units per procedure must be reported when an anesthesiologist performs more than four anesthesia procedures concurrently.
Use Appropriate Modifiers
Always use the correct modifiers with the anesthesia and surgical CPT codes to offer more details. For example, modifiers should be used to explain if the anesthesiologist performed the procedure himself or supervised a certified registered nurse anesthetist (CRNA) and to describe a patient’s physical condition.
Train and Educate Staff
Anyone involved in the anesthesia billing procedure must receive adequate training and education for the accurate documentation of the procedures, calculation of charges, and usage of the correct codes and modifiers. Only trained anesthesia coders and billers can handle the intricacies of anesthesia medical billing.
Adhere to Payer Guidelines
Most government and private insurance payers cover anesthetic procedures. However, their guidelines vary. For example, some payers mandate the use of ‘physical status’ modifiers with anesthesia CPT codes, while others may not find it necessary. Therefore, you must follow each payer’s specific coding and billing guidelines to create clean claims.
Ensure Compliance
You must ensure regulatory compliance throughout the anesthesia billing workflow. Abiding by federal and state laws will guarantee quick reimbursements and save you from legal actions and financial penalties. For example, implement the HIPAA security rule to safeguard your patient’s protected health information (PHI).
File Claims on Time
Late filings are one of the top 5 reasons for claim denials. In 2022, The Healthcare Financial Management Association found that 14% of claims are denied because of late submissions. Follow each payer’s claim submission deadline to prevent denials.
Perform Regular Audits
Quarterly or biannual audits can give you an overview of your anesthesia practice’s financial performance. Comprehensive reporting and data analysis for each step of the revenue cycle can help you understand patterns and identify areas of improvement for informed decision-making.
Outsource Anesthesia Billing Services to MediBill MD MD
Out of all the medical specialties, anesthesiology has the 7th highest claim denial rate. Survey results show that nearly 19% of the claims submitted by anesthesiologists are denied, and the main reasons cited are inaccuracies in the entered information and failure to follow the payer’s policies and billing guidelines.
However, all of the above can be prevented if you partner with a reliable anesthesia billing company and let it be in charge of your practice’s finances. Revenue cycle management (RCM) specialists at MediBill MD work as an extension of your team to provide seamless billing services for improved cash flow.
Partnership with MediBill MD will give you instant access to anesthesia billing specialists who have decades of experience in medical billing and coding. Our AAPC-certified coders are well aware of the intricacies of anesthesiology billing and apply their knowledge to suggest solutions on a case-to-case basis.
At MediBill MD, we offer proven anesthesia billing solutions at a small percentage of your total revenue. Instead of splurging money on setting up an in-house billing team and spiking your overhead costs, entrust us with your non-clinical workload for savings of up to 95%.
We are 100% HIPAA-compliant and ISO-certified. Besides adhering to federal and state laws, we pay close attention to insurance payers’ unique requirements. Our industry-compliant anesthesia billing processes help our clients steer clear of lawsuits and financial penalties.
At MediBill MD, we exercise a human-tech hybrid approach. Before submitting medical claims, we use an automated claims scrubber to identify and fix errors. Once the errors are rectified, our coders run a manual quality assurance check to ensure the submission of clean claims.
With a proven track record of reducing AR days to less than 30, we guarantee our clients faster payment collections and up to 15% revenue upticks. Our anesthesia billing experts streamline the workflow and submit first-pass claims to prevent unnecessary denials and delays.
Unlock success without borders! We provide localized support with our nationwide reach. Our anesthesia billing specialists cater to the needs of private and group practices across the country while diligently adhering to the medical billing rules and regulations in each state.
Leveraging our remote operability, we offer round-the-clock, customized billing assistance to anesthesiology practices from the East to the West Coast and beyond.
Overcome Anesthesia Billing Challenges with MediBill MD
If you think medical coding and billing are challenging processes, wait till you come to anesthesia medical billing. Every step can feel like a whirlwind if you are not prepared for the pitfalls surrounding anesthesia billing.
From applying complicated formulas to matching CPT code sets and comprehensive documentation to using the correct modifiers, inattention to any of these intricacies can lead to claim denials.
| Common Anesthesia Billing Challenges | MediBill MD Solution | |
|---|---|---|
| Miscalculating Anesthesia Charges | Unlike a physician’s service fee, anesthesia charges are calculated using a complex formula. MediBill MD’s anesthesia billing team uses this formula to bill time-based anesthetic procedures accurately. | |
| Missing or Incorrect Physical Status Modifiers | Our staff checks each payer's requirements and uses appropriate Physical Status modifiers (P1-P6) to describe a patient’s overall physical health at the time of anesthesia administration for accurate reimbursements. | |
| Incomplete Documentation | At MediBill MD, we maintain complete and accurate records by integrating your EHR into our systems. It helps us provide supporting documents with the medical claims and collect rightful reimbursements. | |
| Not Prioritizing Timekeeping for Base and Time Units | Base Units and Time Units are needed to calculate anesthesia charges. Our team follows the 1 unit = 15 minutes rule to time anesthesia administration on each patient for calculation. | |
| Forgetting to Specify Medical Direction or Medical Supervision | Our staff asks if the anesthesia was administered directly by the anesthesiologist or a CRNA under his supervision. It is then specified in claims through a modifier. | |
| Incorrect or Missing Modifying Units | Our anesthesia billing staff understands the use of modifying units QS, G8, and G9 to establish medical necessity and inform of changes to the procedure due to emergencies. | |
| Inaccurate Mapping of the Surgery Codes | Anesthesia CPT codes must be mapped with the correct CPT surgical code for accurate reimbursements. Our coders efficiently match these codes to collect anesthesia payments for the surgery. | |
| Not Using Qualifying Circumstances CPT Codes when Required | Add-on CPT codes, known as Qualifying Circumstances codes, are used to explain that anesthesia was performed under challenging conditions. Our team assigns codes 99100, 99116, 99135, and 99140 when needed. | |
Offering painless billing with premium benefits at unbeatable rates! Get our anesthesia practice management solutions at a fraction of your total monthly collections and discover the difference of this partnership within days.
Price Comparison Calculator
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Get In Touch With Our Anesthesia Billing Experts
The first step is always the hardest, but with our experienced anesthesia billing staff by your side, guiding you through the process, you can recover your revenue in no time.
FAQs
MediBill MD’s focused approach to delivering specialized anesthesia billing services at the lower end of the pricing scale makes it a go-to service provider for anesthesiologists. It employs a team of experienced medical coders and billers who use their industry expertise to study each case and suggest tailored RCM services for the anesthetic practice’s financial success.
MediBill MD only charges between 2% and 5% of your total monthly collections for its customized and end-to-end anesthesia billing services.
Calculating anesthesia charges using base and time units and code mapping to align each anesthesia CPT code with the correct surgical CPT code are the most challenging aspects of anesthesia medical billing. These steps require precision and technical knowledge on the biller's part.
