Out of all the administrative tasks you face in your hospital or clinic, you probably least want to be the person faced with organizing anesthesia reimbursement. Chances are your admin and anesthesia staff find it challenging too!
However, your survival as a hospital depends on income, which depends heavily on surgery turnover, which relies even more heavily on anesthesia billing and reimbursement being carried out meticulously.
It’s enough to lose your sleep over – counting and recording base units, time units, modifying units, conversion factors, etc!
To maintain compliance, your staff also need to
- know the correct modifiers,
- stay up to date on billing procedures and payer policies to avoid inaccuracies and rejected claims (sometimes rules change!)
- report qualifying circumstances,
- append physical status modifiers, and
- accurately calculate the time for anesthesia administration – exact hours and minutes.
But the million-dollar question is: Can you entrust the task of organizing anesthesia reimbursement to an anesthesia management service? Will they take the care that’s essential, considering what’s at stake?
After all, it isn’t an instant procedure. It involves a sequence:
- Checking insurance eligibility
- Collecting payment from the patient
- Checking and using the correct codes
- Submitting of medical claims
- Completing payment collection
- Resolving issues surrounding denied claims
- Keeping track of denial statistics
However, when you outsource and happily discover that nothing drops between the sequential cracks, you’ll benefit from
- increased efficiency and compliance,
- proper reimbursement, and, crucially,
- an optimized cash flow.
What’s not to want for your facility?
So – here are the five top benefits you can expect in your anesthesia reimbursement processes after outsourcing services to anesthesia management companies who offer a full service.
Together, these work to significantly lessen your hospital administration tasks.
Benefits of Outsourcing Anesthesia Reimbursement
1 Expertise in Anesthesia Billing
When you partner with an external anesthesia provider, you also gain access to their dedicated billing team.
Their team will have years of experience in anesthesia reimbursement. They can bring their specialized and up-to-date knowledge of coding, documentation, and compliance requirements to the specific needs of your patient population and any type of surgery you specialize in.
This ensures you have both accurate and timely submission of claims – which in turn reduces your risk of claim denials and payment delays. You’ll see this feed positively into your revenue cycle optimization (see below).
2 Streamlined Reimbursement Processes
Linked to the point above, once you’re outsourcing anesthesia services to a group that also specializes in admin, you’ll discover they not only provide expertise but handle the entire anesthesia billing and reimbursement process in a streamlined fashion. They’re used to it; it’s their focus.
- claim submission,
- follow-up, and
- appeals where necessary.
They have proven workflows and systems – using state-of-the-art anesthesia billing – to organize and improve your reimbursement process. This allows you to focus on other critical aspects of hospital administration.
3 Negotiation Power with Insurance Companies
Not all claims for reimbursement go smoothly! It sometimes takes a little extra something to turn a chore into a manageable and successful task!
The “little extra” here is that experienced anesthesia providers have established relationships with insurance companies – and they have history in negotiating contracts and reimbursement rates with minimum stress.
If you take the route of outsourcing anesthesia reimbursement, you can leverage their expertise and negotiation power to secure favorable contracts and maximize your reimbursements.
This ensures that your hospital is fairly compensated for anesthesia services. It’s never good to accept decisions you disagree with, but it takes valuable time to challenge them in the interests of fair play. Your outsourced provider will have experience of challenging successfully.
4 Revenue Cycle Optimization for Anesthesia Reimbursement
We mentioned earlier that your external provider’s experienced staff can focus on optimizing revenue and reducing revenue cycle inefficiencies.
This is key when issues around rules and regulations are costing your facility far more than they used to. (See, for example, the California AB5 regulations.)
However, like a proverbial octopus, your outsourced provider has many arms(!) and can employ multiple strategies to ensure
- accurate and complete documentation,
- proper coding,
- real-time visibility into the status of claims, and
- timely reimbursement.
So – if you tap into their expert methods, you’ll be able to assure your leadership team they’ll see improved revenue optimization and a reduced administrative burden at your end.
5 Cost-Effective Utilization of Resources
Outsourcing anesthesia services allows you to redirect your internal resources to areas where they’re most needed.
By relying on the expertise of the external provider for anesthesia reimbursement, you can free up your administrative staff to concentrate on other critical duties. This kind of efficient resource allocation improves your overall operational effectiveness.
And specifically within the operating room, the lack of stress about concurrent admin leads to a better atmosphere.
Access Customized, High-Quality Administration Services with Meridian
Meridian Medical Solutions is a professional administrative and management group, unique among anesthesia services in California.
We pride ourselves on partnering with you to provide a service that meets your specific and unique needs whether for skilled staff or to manage your regulatory burden – or both.
If you’d like us to be your admin and business consulting team, call us today and discover what Meridian can bring to your facility in terms of outsourced anesthesia reimbursement and much more. Let’s talk!