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5 Myths About Anesthesiology Medical Billing

March 10, 2023

Anesthesiology encompasses perioperative care before, during, and after surgery. Anesthesia providers, like anesthesiologists and anesthesiology assistants, administer different services and levels of care that should be billed separately and through a detailed documentation process.

Anesthesiology is a complicated and multifaceted service, and anesthesiology medical billing can be time-consuming and sensitive to errors without billing expertise. With so much information about medical billing, it can be easy to group anesthesia into the wrong category. Here are five myths about anesthesiology medical billing:

Anesthesiology Medical Billing Is the Same Across All Specialties

Anesthesiology medical billing is not the same across all specialties and requires accurately reported services for timely reimbursement. The success of an anesthesiologist department depends on generating and collecting revenue without delay. To accurately bill for anesthesiology procedures, providers should have detailed documentation, including:

  • Preoperative review: This should have the patient’s family and personal medical history and lifestyle habits, like tobacco use, that were accounted for in calculating the anesthetic dosage.
  • Anesthesia sheet: This documentation should reflect the complexity of the service, time spent monitoring the patient, and any special situations that require additional services.
  • Postoperative review: The closing review should indicate any complications and state the patient’s condition after the anesthesia.

Anesthesiologists Are Responsible for All the Medical Bills Associated With a Surgery

Anesthesiologists are not responsible for all the medical bills associated with surgery. An anesthesiologist administers a dose of anesthesia to a patient, so they do not feel pain during surgery.

Anesthesiologists are responsible for complete perioperative care focusing on the vital functions before, during, and after surgery. Documentation will track services performed by each anesthesia provider so billing can be configured accordingly.

The Anesthesiologist’s Fee Is Always the Same, Regardless of the Complexity of the Surgery

The anesthesiologist’s fee is not always the same, and it varies based on the complexity of the surgery and other considerations. Anesthesia medical billing is often more complex than billing for other specialties and can be challenging to manage with the required documentation and billing formulas. Anesthesia medical billing is based on unique features, including:

  • Base units: The measure reflects the complexity of the surgery and services provided. More challenging procedures require higher skill levels and will have a larger base unit.
  • Time units: Time units may vary by contract but are typically 15-minute increments. Time units accrue while the anesthesiologist delivers care and monitors the patient during surgery until anesthesia care is no longer required.
  • Modifying units: Modifiers can include emergencies or health conditions requiring additional or specialized care or interventions. The modifying units highlight relevant details on a claim and ensure proper payment.
  • Contract rate: Some anesthesia providers have a predetermined rate with an insurance company that is considered during billing.
coronis health anesthesiologist administering anesthesia on patient

Anesthesiology Medical Billing Is the Same as Surgery Center Billing

Anesthesiology medical billing is not the same as surgery center billing and has a unique set of codes and challenges that are often more complex than other medical billing. Anesthesia coding should correctly correlate to clinical documentation to reduce risks of denials, delays, and errors.

You Have to Be a Doctor to Understand Anesthesiology Billing Codes

You do not have to be a doctor to understand anesthesiology billing codes; many certified medical billers are more experienced with anesthesia medical billing and coding and can provide comprehensive revenue management services. While an intricate system, medical billing companies have expert anesthesia billing solutions for a more cohesive structure and maximized revenue.

Coronis Health can streamline your anesthesia billing and provide tailored solutions to your facility’s needs. Our team has several decades of experience in medical billing and revenue cycle management with highly trained and experienced consultants who understand the importance of medical billing and collections. Contact us to learn more about our anesthesia medical billing services and schedule a free financial checkup.

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