It’s common for anesthesia practices to turn to anesthesia billing companies for revenue cycle support. But is your billing company doing what it should be for your physician group?
With regulatory changes inflating the cost to collect and declining reimbursement, many anesthesia practices decide to outsource their RCM functions to a third-party vendor. As a part of this process, providers expect their billing partners to stay abreast of industry changes.
How can anesthesia groups know that their billing company is meeting their billing needs?
While there are many things your billing partner should do, there are three key areas to watch out for to reduce billing and coding errors and safeguard reimbursement optimization.
1.) Ensure processes are in place for accurate and compliant coding.
Accurate, compliant coding ensures the maximum level of reimbursement for anesthesia procedures. The rules for coding and the codes themselves often change from year to year and payer to payer.
It is important to have processes that cater specifically to the intricacies of anesthesia services and not a general “one-size-fits-all” approach to all medical coding.
Questions to consider:
- How is your company educating coders on industry changes?
- How does your company monitor coding performance?
- Do the coders have certification in anesthesia and/or pain?
Not only should regular internal audits occur, but independent audits should also be performed annually to ensure coding is optimal and compliant. Annual provider coding education should happen to educate clinicians on how to address clinical-documentation deficiencies.
2.) Have a strong IT infrastructure with optimized processing capabilities and strong data security.
Most practices highly value Electronic Health Record (EHR) optimization. EHR optimization requires an RCM vendor to have a robust information technology infrastructure and the ability to handle the vast amount of secure data being transferred through interfaces from the hospital, clearinghouses and payers.
Questions to consider:
- Are you confident your information is safe?
- What redundancies are in place, so data is always accessible when needed so billing is not delayed?
- Has your billing company met the requirements of HIPAA HITECH?
3.) Provide detailed, actionable analytics to help improve your anesthesia practice’s billing processes.
With all the data flowing in and out of the billing system, it’s important that you understand what your RCM company does with the data it collects to improve performance, monitor payer contracts and payments, minimize denials, ensure compliant coding and accelerate the billing cycle.
Questions to consider:
- Are you receiving actionable data to gain a better understanding of your practice and the market you’re serving?
- Are you aware of shifts in payer mix and seasonal trends so that you can position the group to mitigate risks and capitalize on favorable trends?
Collecting and reporting of quality data can be daunting and costly for an anesthesia practice. Your billing partner needs to provide you with a user-friendly platform, so you can capture and monitor revenue cycle metrics that are critical to the financial health of your anesthesia practice.
If you were to ask your billing company the questions asked thus far, would you be confident in their responses?
Many anesthesia practices start working with a revenue cycle or medical-billing company but aren’t certain whether their outsourcing partner is doing a good job.
Here are additional questions you need to ask to be sure your billing company is doing what it should be doing for you:
- What are their plans for maximizing your reimbursement with compliant practices now and in the future?
- What investments have they made in information technology and intelligent automation, and how will they keep your data secure and that of your patients?
- Are they providing you with actionable data to make sound financial decisions for your practice?
Contact R1 today if you’re interested in learning more about R1’s revenue cycle services for anesthesia practices. We’re confident you’ll be happy with our answers! Our email address is: Contact@R1rcm.com.
Author Bio: Content is written on behalf of R1 RCM.
