You may use the words “accuracy” and “precision” interchangeably to indicate something that is “correct in all details.” In truth, these words have very different meanings. It’s best to think of it like a dartboard. If you are aiming for the bullseye, but your three darts all hit the wall close together, something for which you were not aiming, your darts landed precisely but not accurately. If one dart hits the bullseye, but the other two don’t even make it onto the dartboard, you were accurate but not precise. If all three darts hit the bullseye, congratulations! Your aim is both accurate and precise. All to say, accuracy AND precision are paramount in your anesthesia billing process. You want your billing process to hit the center of the bullseye every time.
Learn why over 1,100 healthcare providers trust us with their billing and claims management.
Challenges of Anesthesia Billing
The challenges of anesthesia coding and billing are layered. In contrast to physicians, anesthesia providers do not get paid based on the fee-for-service model but rather on start-up, time, and modifier units. In some ways, it’s like a completely different language. Anesthesia coders face many common challenges:
- Mapping the Surgery Code - After determining the proper CPT code for a procedure, the coder must map it with the CPT/ASA codes. As it’s not a one-to-one swap, this is a complex process.
- Timekeeping - Precise time monitoring and documentation is crucial to accurate coding, especially because it’s a time-based reimbursement. When multiple anesthesiologists/CRNAs are involved in a procedure, it gets tricky.
- Determining Status - Knowing the difference between and requirements for medical direction and medical supervision is a crucial part of the coding process.
- Modifying units - Modifying units indicate that the nature of the procedure changed and typically are listed with operating modifiers first and pricing modifiers following. Anesthesia coders must use these modifiers correctly to receive the proper reimbursement.
Any errors in this complex process can lead to inaccurate coding.
Dangers of Inaccurate Coding
Sometimes, the cost of your errors is clear. Compliance issues from bad coding can lead to audits or penalties for fraud practices. Sometimes, however, practices don't even realize what they are missing. Coding that does not accurately account for all of the intricacies of a certain procedure can lead to underpayment of claims. Get paid for the service you have offered! Your revenue stream needs consistency, so you can’t afford delayed payments due to inaccurate billing. And then, you have to fix the errors. This process increases operational costs as you resubmit claims, handle appeals, and address the problems. What is the solution to all these headaches? Outsourcing.
The Value in Outsourcing
Let’s examine how outsourcing anesthesia billing will benefit your practice. Most importantly, you can provide better patient care with the time saved by not handling your billing process. We make it so you can spend less time in the office and more time doing what you love. Rather than maintaining and training your own coders, you can utilize our experienced and trained staff to reduce overhead costs. You will never have to worry about compliance again, as our staff is trained and up-to-date on all the nuances of ICD-10 & MACRA. In addition, we use proprietary software to scrub and validate claims before submitting them and conduct periodic audits to double-check our work. And, of course, outsourcing anesthesia billing improves revenue. A faster claim submission and digital workflow means a better revenue cycle. We can handle claims follow-ups, appeals, and collections for your practice. Tracking changes in your billing process is possible using a dashboard to monitor payments and case volume over time. Remember, you’re only as good as your data.
Improving your accuracy and precision takes time and practice. Put your time to better use by utilizing experienced professionals to handle the billing process.
Contact us today to learn more about the expertise we can bring to your practice.
By Joe Gribbin, Jr., Owner and President
