The value of outsourcing anesthesia billing services

Anesthesia billing processes contain nuances and regulatory specifications that make them different from other medical billing workflows. Following these processes properly is critical to ensuring accurate payments and long-term financial health. Specific anesthesia billing challenges include:

  1. Complex Billing Codes: Anesthesia billing uses a combination of base units, time units, and modifiers to calculate charges. Each type of surgery has a specific base unit value based on its complexity, and time units are added based on the duration of anesthesia care. Billing and coding professionals must maintain precise documentation and have an understanding of anesthesia-specific coding to avoid errors.
  2. Proper Use of Modifiers: Anesthesia modifiers must be properly applied since they are used in billing procedures to reflect anesthesia services provided. For example, modifiers indicate whether an anesthesiologist directed, supervised, or performed a procedure. Incorrect use of modifiers causes denials or reductions in reimbursement.
  3. Reimbursement Formulae: The formulae used in anesthesia billing involve adding the base units to the time units and multiplying the total by a payment or locality conversion factor. Misunderstandings or miscalculations in this area of billing and coding impact revenue.
  4. Regulatory Compliance: Staying compliant with laws and guidelines related to anesthesia billing can be a challenge for non-specialists. Regulations can affect billing practices, patient privacy, and more so they must be carefully followed to prevent legal issues and penalties.
  5. Insurance Verification and Claim Denials: Before anesthesia services are provided, insurance coverage must be verified to ensure that all services are covered. If verifications are not completed before service, anesthesia claims can have incomplete documentation or incorrect coding, which results in denials that delay payment and steal resources from other areas of responsibility.
  6. Concurrency Coding and Tracking: Because anesthesiologists often oversee multiple procedures simultaneously, coding for concurrent anesthesia requires due diligence and efficiency to accurately track the timing and scope of each procedure. This can be complex and prone to errors without a dedicated system and specialized expertise.
  7. Training and Education: When billing staff aren’t trained and up-to-date with the latest anesthesia billing practices, regulations, and technologies, billing errors happen and you end up with rejected claims that must then be corrected and resubmitted. This delays payments and increases administrative workload. Additionally, billing inaccuracies may trigger audits by regulators or insurers.

Specific benefits of outsourced anesthesia billing services

Because of the various challenges and potential pitfalls involved in anesthesiology billing, it’s important to partner with a professional anesthesia services partner that handles your anesthesiology billing and coding needs.

At Valley Regional Anesthesia Associates (VRAA), we provide a comprehensive approach to anesthesia billing management that is tailored to each anesthesiology department’s needs. Here’s how VRAA’s anesthesia billing services can make a difference in your medical clinic:

  • Revenue Optimization: Outsourced anesthesiology billing professionals are adept at navigating the complex reimbursement structures specific to anesthesia care. For example, an anesthesia billing professional can accurately apply anesthesia billing codes, and modifiers, and properly calculate time and base units. These specialized billing services ensure billable services are properly captured and appropriately charged. This reduces revenue leakage and increases your facility’s profitability.
  • Reduced Billing Errors: Anesthesiology billing can unfortunately be subject to numerous errors when managed by non-specialists. This isn’t the case with specialized anesthesia billing professionals like us, however. Because we’re familiar with the nuances and specific requirements of anesthesia billing and coding, we’re able to take billing errors to virtually zero. That means fewer instances of incorrect modifiers being used and miscalculation of base units, which in turn means fewer denied and rejected claims due to coding mistakes.
  • Faster Reimbursement Cycle: When anesthesia billing is efficient and payer requirements are followed, claims submission and follow-up processes are faster as well. Efficient billing accelerates your facility’s reimbursement cycle, improving your cash flow and reducing the administrative burden that accompanies payment delays.
  • Improved Compliance: Anesthesiology billing must adhere to stringent regulatory requirements that can frequently change. When you partner with an anesthesia billing partner, your facility is always on top of the latest compliance guidelines and regulatory changes. This means your anesthesia billing practices are always up-to-date and you can pass audits without significant liabilities.
  • Dedicated Follow-Up and Denial Management: Dedicated anesthesiology billing services include diligent follow-up on unpaid claims and expert management of denials and appeals. Professional anesthesia billing professionals are also able to investigate unjustified denials to ensure that healthcare facilities receive payment due.
  • Enhanced Patient Satisfaction: When your anesthesia billing is compliant and error-free, you have clear and accurate billing statements, which improves patient satisfaction. If patients do have questions, an outsourced anesthesia billing team is available to answer billing questions so your facility builds and maintains patient trust and satisfaction at every step.

Partner with a billing and coding team who knows anesthesia

By partnering with us at VRAA, you ensure that your anesthesiology department’s financial operations are managed with the same precision as your medical services. We identify potential savings in operational aspects and recommend strategies to cut inefficiencies without compromising care quality.

We also provide strategic cost reduction, advising on cost adjustments that maintain or enhance service quality while reducing expenses. Our holistic approach not only secures your financial stability and future growth but also allows your healthcare providers to focus on delivering excellent patient care.

Additionally, our advanced analytics and detailed reporting provide you with insights that support your strategic planning and allow you to identify financial trends and deficiencies. We also provide reports on provider productivity and demographic trends to inform resource allocation and service planning decisions. If you’re interested in our services, contact us!