Anesthesia billing is tremendously complicated. Small errors can result in delays and a failure to collect. Anesthesiology procedures and practices are very susceptible to audits due to its complex
billing practices. The coding, billing, and time factors are often the main concerns for Medicare audits, potentially resulting in the aggressive government investigation and clampdown on funds allegedly used inappropriately. An anesthesia provider faces various challenges like: cancelled anesthesia, failed medical direction, monitored anesthesia care, time issues, and start/stop times. Most anesthesiologists can easily make out when the time when anesthesia was given and when it stops, but they are not always certain about how to handle relief time. Also, as failure to document relief time can cause compliance problem it must be documented
Anesthesiology Medical Billing
Anesthesia billing is tremendously complicated. Small errors can result in delays and a failure to collect. Anesthesiology procedures and practices are very susceptible to audits due to its complex billing practices. The coding, billing, and time factors are often the main concerns for Medicare audits, potentially resulting in the aggressive government investigation and clampdown on funds allegedly used inappropriately.
An anesthesia provider faces various challenges like: cancelled anesthesia, failed medical direction, monitored anesthesia care, time issues, and start/stop times. Most anesthesiologists can easily make out when the time when anesthesia was given and when it stops, but they are not always certain about how to handle relief time. Also, as failure to document relief time can cause compliance problem it must be documented
Common Anesthesiology Billing Issues
Anesthesiology is not exempted from the watchful eye of medical auditors. Multiple recurring issues have been cited by several medical auditors citing the most common problem areas for anesthesiology billing procedures. Anesthesiology billing suffers the same billing problems that other medical billing procedures have. Improper billing procedures are either influenced by perspective, neglect, and at some cases, fraud.
Medical billing is incorrectly regarded as a subjective form of billing, where medical professionals can charge depending on the procedures performed, the instruments and equipment used, and the approximate length of time spent with the patient. Anesthesiology billing is an objective procedure that has a set of guidelines to close the margin for error at a minimum.
Accurate Start and Stop Times
The industry follows Medicare’s definition for anesthesia billing start and stop times. Anesthesia billing start and stop times are based on the continual presence of an anesthesia provider. It is critically important to record accurate start and top times. Do not round your time, and never guess.
Understanding Billing Modifiers
Billing modifiers have a big impact on your charge amounts. There are several modifiers that come into play including:
These modifiers can affect your charge amounts in a variety of ways. Contact an anesthesia billing specialist at Medical Business Management for more information about how these modifiers impact your specific billing situation.
Documentation is Critical
Accurate documentation is the difference between successful and failure in generating cashflow. You can have the best systems available, but if the information that you feed into the system is inaccurate or incomplete, your billings and collections will suffer. Pay close attention to your start and stop times and record them accurately, keep up with the billing. If you log these accurately, your revenue cycle management is set up for success.
Coding, CPT and ASA coding
The American Medical Association sets CPT (Current Procedural Terminology) codes for all surgical procedures. The American Society of Anesthesiologists sets and maintains ASA codes separately. One of the most important steps in revenue cycle management is converting CPT surgical codes to the correct ASA codes. Mistakes in converting these codes can result in long delays in payment. Sometimes it can even render charges ineligible for payment.
Extensive Insurance Follow Up
Securing payment from insurance companies can be a tedious process. Following up with “no pays”, “slow pays”, and “low pays” are necessary to effectively manage your revenue cycle. This is a time-consuming process, but it is necessary to maximize revenue. Simply following up is not enough. The person contacting payors should be an expert in anesthesia billing. An expert will understand common reasons for non-payment, delayed payment, and underpayment. They will know how to present the required documentation to the insurance company to secure payment as quickly as possible.
Conclusion
CareMB associates have been working with anesthesia medical billing for many years. Typically, CareMB can increase revenue significantly. Contact us for more details!
