Selecting A New
Anesthesia Billing Company 

Factors to Consider When Selecting a
New Anesthesia Billing Company

Anesthesia practices often evaluate their options when it comes to finding the ideal billing company. Factors for leaving existing firms include:

  • High staff turnover
  • Missed charges
  • Low collections
  • Lack of AR follow-up
  • Lack of communication regarding AR issues
  • Lack of trust/transparency

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.

Corporate mergers, acquisitions and the continued market consolidation of once independent billing companies can wreak havoc on your practice’s collections and service levels. When billers lose their independence, detailed attention to clients is often lost too. Your billing partner selection is key to the financial vitality of your practice.

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 January 1st, 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.

Responsiveness

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

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 contractingMIPS 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 Jimmy Patrick at (706)-799-9000  or Jimmy.Patrick@msnllc.com.

Hal Nelson, Vice President Anesthesiology Services

CANPC

VP of Anesthesia Services

Hal has 30+ years of experience on both the payor 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 anesthesia billing companies. His broad-based experience ensures that MSN clients have a resource for documentation and billing issues. His past speaking engagements include ASA, MGMA, Dartmouth, and Johns Hopkins.

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These educational documents and guides were prepared as a tool to provide education only. It is not intended to affect clinical treatment patterns. The material provided is for informational purposes only. Efforts have been made to ensure the information within this document was accurate on the date of distribution. Reimbursement policies vary from insurer to insurer, and the policies of the same payer may vary within different U.S. regions. All policies should be verified to ensure compliance.

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