Anesthesia medical billing is a complex component of medicine, requiring accuracy down to the milliliter of dosing for a patient. As intricate as the science of anesthesia is, the revenue cycle is just as challenging. It demands a high level of knowledge from a team that understands the importance of preciseness in coding and billing and the need for overall efficiency. Following these essential tips can help your revenue cycle team create a streamlined process of anesthesia medical billing.
Leverage Technology to Automate and Streamline Your Anesthesia Billing Process
Anesthesia medical billing software is an essential tool that creates transparency in the billing process. Specialized software allows coders and billers to effectively manage the day-to-day operations with hospitals, ambulatory surgery centers, or medical practices.
The technology contained in the programming for anesthesia billing cuts through the processes that create lag times and increases human error.
Integrating technology into your facility’s billing process can:
- Improve coding accuracy
- Streamline claim submissions
- Enhance data integration
- Creates real-time access to comprehensive dashboards to focus on a streamlined revenue cycle process
Technology is not isolated to the coding and billing team; smartphones provide access on the go for anesthesiologists who tune into the bottom line of their facility. Whether in the hospital or the office, a provider can connect with reports or view reimbursements.
From smartphone access to a full suite of online tools, technology provides the necessary tools for a revenue cycle management team to streamline the entire billing process. Anesthesia groups can eliminate duplication, improve resubmission rates, and increase reimbursement.
The anesthesia billing process depends on technology that is current and connects with updated contract rates that match payer databases for accurate reconciliation and customized software that caters specifically to anesthesia services. The coding and billing process is more complex than medical billing, so the revenue cycle team must engage the best technology for the best return.
An anesthesiologist works with the most current equipment and medicines and should expect that the billing software is just as advanced as the process is streamlined to ensure that claims are reimbursed at the highest level possible.
Stay Up to Date on Coding Regulations to Reduce Claim Denials
Anesthesia is a complex process – the doctors are highly specialized in a category of medicine that relies on nothing less than absolute accuracy in every aspect of surgery. One mistake could mean the difference between life and death, so just as these physicians pay close attention to their processes, coders, and billers must stay up to date with regulations and changes to ensure that claims denials are reduced, if not eliminated altogether.
Anesthesia medical coding guidelines are updated consistently based on payer contracts or regulatory changes from the Centers for Medicare and Medicaid (CMS). Changes can be frequent, such as updates from ICD-10 codes that change every October, or CPT changes that update at the beginning of the year.
Certified coders and billers understand the complexities of anesthesia billing, such as the calculation of charges with procedure difficulty, time, and other modifiers that indicate the actual health of the patient. A healthier patient, for example, may not require as much anesthesia, whereas a severely ill patient will require a higher level of anesthesia with stronger medications or more time under the knife. The American Society of Anesthesiologists (ASA) has a specific set of codes and modifiers that relate directly to these factors that determine the amount of reimbursement a payer will remit.
Anesthesia medical coding is not as complicated as anesthesia, but working with experts in anesthesia coding and billing will ensure that reimbursement is maximized. Your facility should rely on a coding and billing team that is in tune with the constant changes that ultimately have a direct effect on revenue.
Use an EHR System for Your Anesthesia Medical Billing
Electronic health records are designed to house medical documentation, with most systems including a practice management component, but medical billing software for anesthesia is designed to maximize every aspect of care for patient anesthesia. If you plan to use in-house billing, using an electronic health record system that has specific functionality for anesthesia ensures that no stone is left unturned in the coding and billing process.
Streamlining your coding and billing process requires that the EHR system falls in line with some simple but critical guidelines:
- Consider the size of your facility – how many physicians or advance-practice nurses (CRNAs) are providing services (smaller EHR might better suit smaller facilities)
- Choose a certified EHR (that is HIPAA compliant and a certified vendor of electronic health record systems)
- Choose what works best for your team – software that is installed on-site or a cloud-based service
- Ability to integrate with technology and equipment
- Interpreting and interacting with provider documentation
- Database of current ICD and CPT codes specific to anesthesiology
- EHR focused on specific sub-specialties (pediatric anesthesia, obstetrics, cardiac anesthesia)
When you choose the right billing system, you are on the way to maximizing your reimbursement with a robust revenue cycle management system built into your EHR.
Follow Up With Insurance Companies to Ensure Proper Reimbursement
Claim submission is not a guarantee of payment from an insurance company. The rigorous process of analyzing a claim requires that the insurance payer follow every guideline and rule related to anesthesia billing. This includes accurate documentation, reporting of base and time units, using appropriate modifiers, and using qualifying circumstances.
One error can lead to a claim denial, but an experienced team of coders and billers will investigate denials to accomplish three tasks:
- Determine what error(s) caused the denial
- Correct the error
- Resubmit the claim
Prior to claim submission, a seasoned team of coders and billers may question potential errors to mitigate denials, but some mistakes are inevitable. Investigating claim denials directly with the insurance companies will guarantee a second look at a claim that could result in higher reimbursement, a reversal of denial, and more revenue for the facility. Encouraging the coding and billing team to keep claim denials at a lower percentage is ideal, but following up on denied claims will ensure that revenue is not left hanging in the wings.
Consider Outsourcing Your Anesthesia Medical Billing
Outsourcing your medical billing does not mean you will lose control of your revenue cycle process. Providing your team with a higher level of flexibility and more time to focus on important administrative tasks will accomplish more than just an increase in employee satisfaction. Outsourcing your medical billing for anesthesia improves your bottom line.
Experienced anesthesia medical billing services, like Coronis Health, can provide your facility and anesthesiologists with peace of mind and confidence that your denial rates and rejections will decrease, while reimbursements will continue to grow. A dedicated team of experts who focus solely on anesthesia coding and billing can provide you with time to focus on what counts the most – your patients. When you want the best for your facility and for your patients, choose what will make the difference. Choose Coronis Health for your anesthesia billing needs – contact us today to start earning more revenue for your facility.