Service
Anesthesia billing and revenue review
“Is the group collecting what the work should earn?”
Anesthesia is billed differently from almost everything else in the hospital: base units, time units, modifiers for medical direction and supervision, and payer rules that change each year. General medical billing often gets it wrong.
Under a subsidy, what the group fails to collect tends to come back to the hospital as a request. We review the group’s billing and collections against your own case and time data, so you know whether the subsidy is funding a real gap or a billing problem.
What we look at
- Collections by payer class and per case, over time
- Billed anesthesia time and units against start and stop times in your records
- Medical direction and supervision modifiers and their documentation
- Denials, charge lag, days in accounts receivable and write-offs
- Payer mix as billed, compared with your registration data
- The billing arrangement itself: who bills, at what fee and with what audit program
What you get
- A billing and collections scorecard for the group
- The gaps that are costing collections, with an estimate of each
- Data-rights and reporting language for the next agreement, for review with counsel
- What to look for if the hospital employs anesthesia staff and needs its own billing partner
What we need from you
- The group’s billing and collections reports, or a contract right to request them
- OR case data with anesthesia start and stop times
- Payer mix from registration data
- The current agreement and any billing provisions
Right for you if
- The group asks for more while its collections data is thin or missing
- Collections fall while case volume holds
- You are about to employ anesthesia staff and need to choose a billing partner
Probably not a fit if
- You need a certified coding audit for compliance purposes. That is a coding auditor’s job, and we can help you scope it
Questions
- Are you a billing company?
- No. We do not bill for anesthesia services and we take no fees from billing companies. We review billing on the hospital’s behalf.
- What if the group won’t share billing data?
- We estimate what the group should collect from your own case, time and payer data, and label those figures as estimates. A group that won’t share data while asking for a larger subsidy is itself a finding.
- Why does anesthesia need specialist billing?
- Anesthesia is paid on base units plus time, with modifiers that change the payment depending on who did the case and how many rooms an anesthesiologist covered. Small errors in time or modifiers add up across thousands of cases.