By Mary Barbour
As a medical practice, you want your company to run as smoothly and efficiently as possible all while making the most important part of your business, your patients, feel cared for. The healthcare process extends from the moment the patient first visits a doctor’s office until long after they have recovered from the procedure.
Billing for healthcare services can be a tricky situation if not conducted properly. You want the patient to be aware of the charges from the start and to make sure that insurance coverage, if applicable, has been confirmed and taken into account.
Since anesthesia charges are often billed and paid separately from the actual procedure, there is a lot of room for error in the billing process. Avoiding mistakes can help you improve the efficacy of your practice as well as ensure the patient is left with a good impression of your practice. Here are some common problems that should be avoided when billing for anesthesiology:
Waiting to confirm that the patient’s insurance will cover the procedure
This is an important step in making sure that the patient doesn’t get any billing surprises, and also in increasing the likeliness that you are paid in full for your services. Sometimes insurance companies will cover a procedure or operation but the coverage won’t include anesthesia. Make sure that you and the patient have all knowledge of what is covered and what is not.
Erroneous or inexact start and stop time
It’s important to make sure that the start and stop time is recorded and billed exactly as outlined in your contract. There should be adequate monitoring in the operating room to ensure that the time is recorded precisely. Rounding time and/or billing for time before or after the start or finish is a mistake that can easily be avoided.
Certain coding issues can cause inaccurate billing. Entering incorrect codes for procedures or not properly documenting the procedure can create a faulty bill.
Including additional services
Ancillary services can create billing problems; for example, if there is a failure to document that the surgeon requested the procedure. Make sure additional services are outlined and clearly documented.
Unclear definition of services
Services should be listed individually with their own CPT code, otherwise they will not be broken down and billed separately. With ICD-10 changes around the corner this will before even more important.
MAC vs. General vs. TIVA
Different types of anesthesia have different billing codes, which can cause confusion when billing. Having clear documentation on exactly which type of anesthesia is being used and making sure this carries through to the billing stage can help avoid such confusion.
As surgical services are beginning to take place in a wider variety of settings, there is less control over the way procedures can be monitored. Billing for anesthesiology is complicated enough and these new issues can pose problems that may affect your revenue streams. Don’t let the final step of a patient’s experience with your practice keep them from coming back again.
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.