When it comes to coding and billing compliance, there are very few anesthesia practices that don’t have a solid understanding of how important compliance is from a legal and regulatory standpoint. After all, nobody wants the Office of the Inspector General (OIG) knocking on their door.
What many practices overlook, however, is the vital impact of coding and billing compliance on their business relationships. Although compliance certainly affects revenue, it is also part of a bigger picture: your reputation management — and the benefits that become possible by building strong business partnerships.
Developing and adhering to a solid anesthesia compliance plan helps to create transparency — both within the practice and with business partners. The last thing a hospital wants to deal with is bad publicity (and subsequent costs) caused by an inadequate compliance plan with its partnered anesthesia group.
Hospitals value a partnership with a practice which can easily demonstrate the importance of compliance. It reflects a practice culture that pays attention to the nitty-gritty. Hospital leadership can therefore have confidence in working with a practice whose reputation in compliance is aligned culturally, economically, and clinically with theirs and can help further their mission.
Consider this scenario for a moment: Your hospital contract is coming up for renewal. Simultaneously, a national anesthesia management competitor is reaching out to the hospital promoting, among other areas, the rigor of their compliance program. Your response may sound weak if your anesthesia practice has never before broached the subject of an anesthesia compliance plan with the hospital.
On the other hand, if you’ve held proactive discussions with the hospital about your dedication to compliance and associated policies, then it is one less area that a competitor can exploit to grab the attention of hospital leadership. The practice isn’t taking a defensive posture to explain its compliance efforts at the ground level. Instead, the practice can reference past examples and build on those discussions. It could be just the connectivity and proactive communication needed to help differentiate your practice’s reputation from others. This type of personalized touch can provide the competitive edge needed to help sustain a long-term, committed partnership.
While being a good steward and taking a proactive approach is a solid start, it’s no secret that it’s hard for practices to demonstrate their value in a hospital environment where anesthesia functions behind the scenes and is often viewed as a cost center. Yet there are steps practices can take.
One simple idea is to build a reputation as an active participant in the hospital’s affairs outside the confines of the operating room. Joining a leadership or compliance committee, for example, increases visibility, demonstrates leadership, and shows solidarity with the hospital’s compliance and care missions.
Anesthesia practices need to think “big picture” about all the ways that coding and billing compliance can help reinforce their business partnerships. Fostering a good compliance reputation helps when it comes time to renegotiate your hospital contract. It’s much easier to demonstrate your value if you’ve already built that kind of transparency and trust with hospital leadership.
The unquestionable impact of sound coding and billing compliance on the revenue cycle certainly can’t be forgotten, either. It reduces denials, which can lower the time and cost associated with cumbersome appeals processes. It ensures that clean claims go out the door faster, enabling a more stable cash flow. Compliant coding and billing procedures bring such bottom-line benefits to the table both for anesthesia practices and their business partners alike.
Look holistically, anesthesia compliance can be about more than simply staying out of regulatory trouble and maintaining a healthy revenue stream. It’s an opportunity to build a positive reputation — a reputation as an anesthesia practice with which hospitals want to partner and evolve with.
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.