SELECTING A NEW ANESTHESIA BILLING COMPANY
FACTORS TO CONSIDER
Anesthesia practices often evaluate their options when it comes to finding the ideal billing company. Factors for leaving existing firms include missed charges, low collections, lack of AR follow-up, staff turnover, pricing, and lack of trust.
However, to make such a change, the first thing that must be done is finding and reviewing the existing contract between you and your current Revenue Cycle partner.
Review Existing Contract
Most billing contracts have a 3-year initial term with an “evergreen” clause, meaning that the contract auto-renews for one year on the anniversary of your start date.
Groups wishing to get out of a billing contract typically have to notify their vendor in writing, more than 90 days in advance of the auto-renewal date. For example, if a contract’s renewal date is 1/1/22, you’d have to give notice by the end of September, to be able to legally cut ties and transition to your new billing firm, without cause.
Unfortunately, many practices are unaware of this requirement and miss
the notification period window, thus being stuck for another year with a company that they’re displeased with.
AR Collections & Follow Up
Groups can become discontent with billing vendors for several reasons. The first is AR collections and follow up. Practices want billing firms that aggressively work non-paid line items and claims, and don’t just collect the “low hanging fruit”.
Lack of proactive feedback on documentation issues, payer policy changes and payment trends is also a deal breaker , as groups need to be aware of the root causes affecting their bottom line.
A good billing company should already know the answer to why your collections are down and have an action plan in place, prior to you having to ask. That’s what you pay them for.
Another cause of dissatisfaction is lack of responsiveness. If a group administrator or member asks a question of the billing company or requests analytics regarding a particular service line, your vendor should be prompt with a response.
Business intelligence platforms allow for ad hoc queries to be run quickly, so if you’re continually having to remind your billing contact of outstanding items, something is wrong.
Trust is the most important factor in any business relationship. To this end, you should have access to all data pertinent to your billing. This includes “read-only” access to the billing platform itself for all key practice personnel. If your billing firm has a BI tool, you should ask permission to be granted credentials to run your own queries.
Lastly, if your collection agency is owned by your billing company, consider whether this makes sense. Since collection agencies charge up to 10X your normal billing fee, is your revenue cycle vendor truly incentivized to collect all that they can?
Value-adds such as managed care contracting, MIPS reporting, and patient satisfaction surveys are offered by select anesthesia billing firms. For MIPS, look for companies that use Qualified Clinical Data Registries (QCDRs), so that you’re able to license other proprietary measures and create some of your own.
Having these add-on features allows for discounted pricing and keeps such services under one umbrella. If your current billing vendor only offers some of these services, consider whether you’d be better suited with a firm offering a more robust portfolio.
Billing Partner Selection
In the end, your billing partner selection is key to the financial vitality of your practice. If you’re not getting optimal performance from your revenue cycle firm, perhaps it’s time to explore other options that will yield superior results. To find out how MSN Healthcare Solutions can take your practice to the next level, please contact Steve Collins at 970-988-2654 or firstname.lastname@example.org.
Vice President, Client Relationships, & Business Development
Steve has successfully worked in sales for both revenue cycle management companies as well as market-leading radiology practice management and radiology information systems. He has been involved with the Radiology Business Management Association (RBMA) as a member of the Board of Directors for the national organization as well as revitalizing the Colorado RBMA chapter and serving as its President.
Hal Nelson, CANPC
has 30 years experience on both the payer and RCM side, with a focus in Anesthesia. He formerly worked as a senior claims approver at United Healthcare, as well as a compliance officer for multiple national billing companies. He has also taught the CPC coding curriculum collegiately in Atlanta. His broad based experience ensures that MSN clients will have a resource for documentation and billing issues. His past speaking engagements include ASA, MGMA, Dartmouth, and Johns Hopkins.