The benefits of an anesthesia-focused revenue cycle management approach
June 27, 2023
Anesthesia billing is a unique and complex process. That’s why healthcare facilities often partner with a management company to handle their financial needs and maximize profitability. However, not all anesthesia management partners are created equal. Some only focus on medical billing, ignoring the entire concept of a revenue management cycle (RCM). While accurate billing is crucial, a more data-driven approach, like RCM, can provide additional advantages.
Anesthesia-related billing challenges facing medical facilities
Anesthesia billing involves intricate calculations based on factors such as surgical procedures, the patient’s health, and contracted rates. The process begins with a patient seeking medical treatment and ends when payments are obtained from both the patient and insurance provider; however, steps in between must be executed with precision and timeliness to guarantee that the insurance company approves the claim and makes a payment.
The people who handle this type of billing need an in-depth understanding of anesthesia coding rules and guidelines. Without the proper knowledge, it can lead to errors in documenting anesthesia type, applying correct modifiers, and adhering to time-based billing regulations. Such mistakes might result in more than lost revenue through claim denials, legal problems, and regulatory issues. Given this complexity, an anesthesia management partner needs to comprehend the different stages involved.
Medical billing and revenue cycle management are not the same
RCM is more than just billing – it encompasses every aspect of the anesthesia claims process and serves as a complete approach to perioperative workflow. From appointment scheduling to eligibility confirmation, care practices, documentation, medical billing and coding, submitting claims, and collecting payments, RCM covers it all to optimize healthcare facility profitability.
A complete approach to maximizing healthcare profits
Because anesthesia financial considerations are more complicated than most other medical fields, bringing in a partner specializing in anesthesia revenue cycle management is vital for hospitals and clinics looking to optimize their financial performance. By taking a proactive approach to the complete billing cycle, healthcare teams can improve their organizations from top to bottom.
Streamlined workflow – With a complete RCM strategy, hospitals and clinics can optimize their programs, minimize mistakes, and improve cash flow. By fine-tuning tasks such as scheduling, coding and billing, and payment processing, the burden on staff is reduced, freeing up time to focus on non-administrative responsibilities.
Improved patient experiences – Healthcare providers’ primary focus is always on delivering top-notch medical care to their patients. However, this can be challenging when medical billing tasks take up significant attention. Working with a skilled RCM partner allows providers to free up time and resources to focus on what really matters: providing quality care.
Increased profitability – Optimizing revenue is essential for the financial stability of a medical practice. Ensuring prompt reimbursements requires accuracy, and with the right partner, data collection, insurance verification, and coding are significantly streamlined and precise, increasing profitability.
With RCM, organizations also gain greater visibility into their operations, allowing leaders to identify issues and make more informed decisions, ultimately ensuring financial viability. In short, RCM is a crucial tool for any healthcare organization aiming to maximize revenue and streamline its billing processes.
A partner that goes beyond billing
At Premier Anesthesia, we realize that each provider model is unique, so we bring our expertise to the table to assist facilities in enhancing their billing workflows, capturing all anesthesia service revenue, benchmarking against financial projections, reducing accounts receivable, and avoiding compliance risks. Our extensive range of services extends beyond billing and reimbursement, streamlining every aspect of your financial operations through revenue cycle management. Whether you are a hospital, outpatient clinic, or office-based medical practice, we know what it takes to run a successful perioperative program. Find out more.