Anesthesia Billing – Unique Requirements

Monday, March 25, 2013 6:22 Share
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A common myth about Anesthesia Providers is that their work simply involves giving anesthesia to the patient undergoing surgery. In reality, they have more responsibilities like creating a customized anesthesia plan for a patient, monitoring the health status prior to and after giving anesthesia, and more. Anesthesia providers may range from Anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and Anesthesiologist Assistants. Like how treating a patient with the right anesthesia is vital, billing anesthesia services the right way is also very important. Different from the usual healthcare billing process, it has some unique requirements. The most challenging part of anesthesia medical billing is the clear documentation of records which are briefed below,

  1. 1.    Pre-operative Review: In this review, the patient’s health history is thoroughly analyzed to find risk factors like cardiac complications and more. It helps anesthesiologists to tailor a custom plan for the respective patient.
  2. 2.    Anesthesia Sheet: It involves the documentation of the following factors,
  • Base Units: They are derived by measuring the complexity and skill set required in providing anesthesia services. More intricate procedures earn a higher number of base units.
  • Time Units: The amount of time required to render anesthesia services helps derive time unit factors.
  • Modifiers: Factors like patient’s physical status, co-morbid conditions, emergencies, concurrencies and more have to be taken into account in anesthesia medical billing.
  • Conversion Factor: A fixed dollar amount set by the anesthesia group belonging to each state.
  • Formula: (Base Units + Time Units + Modifiers) x Conversion Factor = Anesthesia Reimbursement       
  1. 3.    Post-operative Review: Monitoring a patient’s health condition and rendering appropriate pain-block services after surgery is very important. Anesthesiologists are expected to document them for proper anesthesia medical billing.  

Improper Documentation: Sometimes, anesthetists fail to document their services properly or their documents might be erroneous due to their busy schedules. It may lead to claim denials or underpayment, thereby affecting the revenue cycle management. The ideal solution to overcome this situation is to outsource anesthesia medical billing to an offshore company like e-Care India.

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