The submission process for anesthesiology services can do using the CPT-4 codes or the codes decided by the ACA (American Society for Anesthesia). Use of the right modifiers is one of the critical factors to denote the right value and the actuality of service being provided personally. The formula is simple: (Base Units+ Time Units) x Conversion Factor = Reimbursement.
It is important to note that each CPT code is assigned to a particular base unit. Two units of time will be equal to 30 minutes and 38 minutes of anesthesia service may be rounded up to 3 units. 37 minutes will be further rounded down into two units. Any claims processing system will be calculating the time units based on the total time of the anesthesia service being provided.
The reported time is actually a combination of multiple complex procedures that is involved in a single process of anesthesia. The reporting process has to be continuous and the present status represents the consistency in contact between the patient and the physician. Explaining the qualifying circumstances and the correct action will be a key aspect.
Understanding what is going to be paid and what not is the key in anesthesiology billing and collections. Elevating your present day practice management efforts will be crucial to your business survival. How you will be capturing information and using it for better translation of the medical procedure involved is going to be an indispensable credential. To manage an end to end revenue cycle management in anesthesia billing, it will be important for you to identify and pick resources that understand the claims adjudication dynamics.
Medical coding has evolved with time and a competent coder today will be able to interpret the entire process correctly. While it is true that a medical coder will be a translator and is not directly involved in the billing process, yet the right perspective that gives transparency with laid guidelines in accordance to ICD-10 will be vital.
Medical billers that are aware of the functional best practices in anesthesia billing will implement a sound methodology for improving accounts payable. Dedicated AR experts will follow up on denials and will improve entire collections with 100% HIPAA compliance in the entire operational process. Today, it can be safely said that a quality medical billing company that has a disciplined mindset about modern payer mindset will be adding a huge. They will guarantee a quality increase in collections and reduce in-house billing costs.