Anesthesia Billing


The Anesthesiologists are the unsung heroes during a surgery. While their role is either not understood clearly or marginalized, it remains their responsibility to administer the right amounts of the drug so that patient undergoing surgery feels no pain, and also to wake them up from sedation after the surgery is completed.

The work of an Anesthesiologist, in fact starts during the pre-surgical phase when they determine the drug and the amount to be given based on the history of the patient. They also need to monitor the patient actively during the surgery and adjusting the dosage being given. There are different levels of Anesthesia providers - the Anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and Anesthesiologist Assistants (AA). While they take on a critical role, it is only justified that they get billed correctly for their services and get reimbursement to the maximum.

The most challenging part of anesthesia medical billing is the clear documentation of records as below:

Pre-operative Review: In this review, the patient’s family and social history are documented including any dependencies on tobacco, alcohol or other drugs to decide and arrive at the correct dosage of Anesthesia to be administered.

Anesthesia Sheet: It involves the documentation of the following factors,

Base Units: The complexity and skills involved in delivering the services form the Base Units. The more complex the procedure, the higher the value of Base Units.

Time Units: This is the time spent with the patient, either administering the anesthesia or monitoring the patient’s condition throughout the surgery and later.

Modifiers: There are other factors like the patient’s prior health condition, presence of co-morbidity factors and other considerations to be taken into account in anesthesia billing.

Conversion Factor: This is a fixed dollar amount set by each anesthesia group belonging to that state.

Formula: (Base Units + Time Units + Modifiers) x Conversion Factor = Anesthesia Reim bursement

Post-operative Review: It is vital that the Anesthesia provider revives the patient out of the Anesthesia once the surgery is completed. The monitoring and ensuring that the patient did not suffer any complications due to Anesthesia also needs to be documented for proper anesthesia billing.

e-care has specially trained teams that exclusively handle Anesthesia medical billing. With more than $ 64 million collected in 2013 only for Anesthesia providers, e-care has both the expertise and the bandwidth to service clients of all sizes in Anesthesia.