Revenue Cycle Management

The intricate billing practices associated with anesthesiology procedures and practices render them highly susceptible to audits. Medicare audits primarily focus on coding, billing, and time factors, which can trigger intensive government investigations and clampdowns on funds suspected of being used inappropriately. 

For over three decades, the experts at Coronis Health have worked with anesthesiologists in small or large groups. Coronis Health provides certified coders and medical billing specialists experienced in anesthesiology billing with all the nuances it entails.

Anesthesia RCM & Claim Management

• Early identification and tracking of self-pay accounts
• Electronic claim & remittance processing
• Insurance verification
• Concurrency coding and tracking
• Unparalleled claim tracking & collection follow up
• Line item posting
• Unlimited charges, payments & adj. tracking by the provider, site, code, surgeon, zip, ICD, etc.
• Lockbox receipt protection
• Electronic access links to your hospital
• Secure & protected electronic archiving of records.

Anesthesiology is scrutinized by medical auditors, who have cited numerous recurring issues in this area. Like other medical billing procedures, anesthesiology billing is also prone to various billing issues. These can arise due to perspective, neglect, or, in some cases, fraud.

While medical billing is sometimes perceived as a subjective process, allowing medical professionals to charge based on factors such as the procedures performed, equipment used, and time spent with the patient, anesthesiology medical billing is, in fact, an objective process. It is guided by a set of specific guidelines which aim to minimize the margin for error.

Revenue Cycle Optimization & Reporting

• Accounts Receivable Management & aging
• Expected vs. actual payment
• Underpay monitoring and follow-up resolution
• Payer mix analysis
• Payment punctuality by the payer
• Provider productivity reporting
• Case volumes and trending
• Demographic trending
• Revenue projections and opportunities
• Executive “Report Cards” and management reporting

Advanced & Unlimited RCM Reporting Capabilities

• Complete database transparency & access
• Unlimited ad-hoc & custom ad-hoc database
  queries

Potential Challenges with Anesthesia Revenue Cycle Management

Billing, coding, and documentation affect anesthesia practices in many ways. If not proactively managed, they can increase the risk of inefficiency, auditing, malpractice suits, and revenue loss. Accuracy in coding is essential not just for billing and revenue purposes but also impacts clinical preparedness, statistical databases, and the overall organization of your practice. 

Challenges in billing and revenue cycle management involve the following factors:

• Knowing the different types of billing codes – anesthesia is a complex specialty, and billing for it involves identifying various services beyond administering an anesthetic. It encompasses the preoperative evaluation of the patient and other supportive services. A thorough grasp of the services and their billing codes is necessary to ensure accuracy in billing and documentation.
• Using the correct modifiers – modifiers identify specific details on an insurance claim by indicating whether an anesthesia service was personally performed, medically directed, or supervised by an anesthesiologist. Modifiers can lead to duplicate billing, unbundling, or denied claims when used incorrectly.
• Understanding the correct formulas to use for reimbursement – when filing an insurance claim, a specific formula must be used:
  • Base Units + Time + Physical Status Modifier = Total Units. 
  • For Medicare:  Base Units + Time = Total Units. For quicker reimbursements, accurate codes and modifiers per the guidelines provided by The Centers for Medicare & Medicaid Services (CMS) and state regulations must be used.

How Outsourcing Your Medical Billing RCM Can Help

Outsourcing revenue cycle management and billing services allows anesthesia facilities to increase coding efficiency and compliance for improved cash flow. With an experienced anesthesia RCM company as your partner, you gain the following benefits:

• Optimized workflow and streamlined processes – automated tasks create efficiency in your processes that enable your practice to run like a well-oiled machine. An electronic workflow allows fewer errors and improved scheduling and payment processing, helping you optimize your system for more accurate billing and faster payments.
• Quality coding and reporting – before the RCM process even begins, your RCM partner meets billing compliance standards by remaining abreast of the latest government rules, regulations, and coding changes. Experienced billers and coders perform the meticulous job of distinguishing data that needs to be reported. As certified coders, they know exactly how to evaluate every clinical procedure and identify them with accurate codes and modifiers.
• Improved claims tracking – your partner’s advanced technology and reporting tools seamlessly track electronic claims. Not only do they get coding right the first time to reduce claim denials and speed up the reimbursement process, but they ensure appropriate follow-up too. They make the extra effort to go after every last dollar you are owed.
• Faster payment collections – time-consuming tasks, such as data collection and entry, insurance verification, and coding, are performed faster when your facility is equipped with the most advanced revenue cycle management software solutions and technology.

Questions? Contact an Anesthesiology Medical Billing Expert Today!

With decades of experience, Coronis Health can provide tailored and flexible solutions to meet your practice’s RCM needs. We understand the importance of working down AR. As technological innovators, we analyze your current workflow and utilize the latest anesthesia RCM software to streamline your anesthesia billing, achieve efficiency, and maximize your cash flow. Would you like to learn more about anesthesia billing tips and how we can build the best RCM system? Contact Coronis Health to request your free financial checkup today.