Anesthesia billing is why we love this business. What distinguishes and at the same time complicates anesthesia billing from other specialties is that 90% of anesthesiologists in America are non participating providers, or Out-Of-Network(OON) providers. To solve this dilemma one must take a rather unorthodox approach at anesthesia billing. We like to think of anesthesia billing like building blocks. You start with different payer mixes, and factor in each of their properties. Every payer reimburses a different rate, including those with different plans servicing the same geographical location. Hence, each claim must be analyzed for their paying characteristics, i.e., patient deductible, plan type, allowed amount, and most importantly the status of the surgeon and the facility where the service took place. Often this process is further complicated by the constant changes and state laws governing OON reimbursement rates. Other times, the constant lack of training within each payer’s claims department further complicate the matter, resulting in unpaid or partially paid claims. With a long and successful history in anesthesia billing, as well as a trained and dedicated team, we will help you avoid the OON pitfalls and maximize your revenue.
Sending correct claims is the first step of the process. Often mistakes are made resulting in denied claims due to inaccurate billing. A lot of effort is needed to correct such mistakes. In Medsol Billing LLC we’ve solved this problem altogether. A team of certified professional coders converts every service accurately into ICD-10 and CPT codes starting from Patient’s diagnosis, treatments, supplies and services provided to the patient. Claims are then prepared by checking all factors, from eligibility, appropriate modifiers to following payment policies to ensure all claims get paid in due time.
Claims Processing and Medical Coding
We are very proud of our experience with anesthesia billing having served many practices in NY and NJ over the last decade.
Throughout these experiences we have learned, developed and improved much of our billing processes. Today, we are able to analyze, interpret, and advise on any and all scenarios related to anesthesia billing, regardless of specialty.
These abilities, coupled with a well trained team, are not only what distinguishes us, but the guarantees for quality service and increased profits for your practice.
Our Anesthesia Billing Experience
Keeping track with insurance carriers policies regarding fee schedules can mean the difference between claims getting paid or denied. This means keeping track of health payer claim edits, updates on insurance companies’ payment rules and changes in reimbursement rates. We can provide clear answers to these questions for maximized revenue by helping you adapt fee schedules accordingly.
Fee Schedule Analysis
As patient out-of-pocket expenses and deductibles increase over time, anesthesia practitioners find it harder and harder to collect these payments. Part of this dilemma is the fact that anesthesiologists, regardless of servicing a OBS or Facility, don’t have front office staff who would collect these payments prior to procedures, or subsequent procedures.
We tackle this problem by closely following up with your patients.
Whether by phone calls, emails, or statements with pre-paid envelopes, our team will keep track and actively engage all patients who owe you money.
Following up with Patients
Electronic claims filing is now a common practice and we at Medsol Billing LLC offer great convenience with integrated clearinghouse services. Through them our clients enjoy the benefits that this service has to offer. Get paid faster! Our staff can submit claims electronically to more than 2500 government payers and commercial insurance companies. Obtain claim processing reports with status update on your claims. Save time by automatically posting insurance payments through Electronic remittance advice. Receive electronic remittance advice reports, receipt of electronic funds transfers and more.
We understand the challenges anesthesia practitioners face when deciding to enroll in payer’s provider networks, or bill their services out of network. Since day one, we’ve had the chance to provide services as in-network as well as out-of-network and are more than familiar with the issues that accompany each form of billing. Through this knowledge we are confident we can present you with the solutions that will best suit your position, providing insights regarding Superbills, Usual Customary and Reasonable Rates, balance billing and ensuring you’re complying with all state and federal laws.