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Healthcare billing has become so complex that the industry has had to create a whole new job description, patient navigator, to guide patients to understand their medical bills.

A recent blog post on KevinMD covered this topic and it still strikes a personal note for me. In the article, the author laments the fact that he has trouble understanding his own medical bills — despite being a practicing physician. While real reform is the answer to the problem, he makes another crucial point: Sometimes, all we need is a little help.

Anesthesia needs a patient navigation service more than other medical specialties since the anesthesia medical billing experience is even more complicated. Fortunately, we are in a perfect position to help patients better understand their healthcare bills.

By reaching out to educate patients, practices can provide a valuable service that patients genuinely appreciate. Plus, it often leads to improved payments since revenue and a patient’s timeliness and willingness to pay is impacted as much by the financial experience as the clinical experience.

Common patient collections hurdles

After spending nine years working for collection agencies and training thousands of people on collection strategies, I’ve noticed some common opportunities for internal and external billing education. First, here are a few things practices should understand as they help patients navigate their bills:

  • Most patients don’t see a difference between professional and facility services. For many patients, it’s confusing and frustrating to receive multiple bills related to the same procedure. They assume any payments they make to the hospital satisfy all their financial obligations. They don’t realize that the services of the anesthesiologist, surgeon, etc., are paid separately from the hospital’s facility fees. They may believe they’re being double-billed, and simply disregard statements from their anesthesia group as a result.
  • Some patients believe anesthesia medical bills can’t go to collections. There’s a common misconception that medical bills are different than other types of debt. In some cases, patients prioritize paying other bills over their medical costs because they erroneously think those balances won’t go to collections. In fact, when I worked in collections, I too often talked with patients who were upset that this wasn’t properly explained to them.
  • There’s a difference between asking for payment and a collections strategy. Traditionally, collectors in healthcare organizations are trained to call patients and request a payment. Seldom are they really taught how to collect. That entails setting payment expectations in a way that’s both effective and collaborative. For example, a collection strategist might request a $500/month payment and negotiate to $150/month, which leaves the patient satisfied and more likely to pay. Contrast that with the frustration of a patient who offers to pay $20 when asked, “Can you make a payment today?” but then is told, “I’m sorry, but our minimum payment is $50.”

Proactive patient education works better

To create a more positive anesthesia medical billing experience, all patients need is a little help. Anesthesia practices may want to consider offering an educational “bridge” between the patient, the insurance company, and the practice’s billers.

This can take the form of a proactive phone call just to provide information and collaborate with the patient on their anesthesia bill. Such calls should start by reassuring the patient that you’re not a collection agency; rather, you’re calling to help them cut through any confusion and stay out of collections.

Then take time to explain how billing works. For example, clarify that hospitals only bill for their facilities and supplies, while practices bill separately for the time and effort of the medical professionals — like the anesthesiologist, CRNA or anesthesia assistant — who provided their care.

Answer any questions, and gather details about any secondary insurance that might assist with costs. Explain both how much insurance has already paid, and how much responsibility remains. Refer them to a biller or their insurance company for questions about their balance, but also invite them to pay their portion of the bill over the phone.

The value in this highly educational and collaborative approach leads to better financial results for the practice and higher satisfaction for the patient. For example, we’ve seen increases in hourly collection averages up to 300% — and at a lower cost. (Billing companies typically charge as much as five times less than collection agencies.)

At the same time, this approach reduces patient confusion, frustration, and complaints to the hospital about being double-billed or sent to collections. That, in turn, can lead to a better relationship with the hospital for the anesthesia group.

Best of all, though, is the satisfaction patients feel from a more collaborative relationship with their providers. From the patient perspective, the care experience isn’t complete until the billing is complete. Practices that want high ratings on the quality of their care must also pay attention to the quality of their billing.

Payment and satisfaction go hand-in-hand

Some studies have shown that patients satisfied with the billing process are twice as likely to recommend the physician and five times more likely to recommend the hospital. Other studies have shown that while 74% of satisfied patients pay their bills in full, only 33% of less-satisfied patients pay in full.

Despite ongoing conversations around healthcare reform, for now, billing is likely to remain an area of confusion for patients. Medical billing companies can add value to the anesthesia practices they serve by taking a proactive approach to patient education. Through skilled, informative and collaborative discussions with patients, practices can gain more financial security, better hospital relationships, and higher overall patient satisfaction.

Contact us today to learn how we do more to improve your patient’s billing experience and improve your collections as the patient responsibility continues to grow.


abeo Management Corporation (abeo) serves as a leading source of revenue cycle management and practice management with a specialization in anesthesia. The company leverages its people, processes, and software to serve independent practices, surgery centers, hospitals and healthcare systems with a scope of services that include billing, coding, transcription, practice management, and business consulting.

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