Nick Carroll, President of South Care Billing, Inc.–
Billing Partner for Clinical Colleagues, Inc.
Many small to mid-sized hospitals in the U.S. report that their anesthesia departments weigh down, rather than support or boost, their bottom line financial results. While it’s not likely that your hospital can turn your anesthesia service into a significant profit center, there are some things than can and should be done to assure you are optimizing your opportunities for anesthesia reimbursement. By implementing a few relatively simple, yet critical processes within your organization’s coding, credentialing, training and billing operations, you can assure that every anesthesia dollar that should be collected, will be.
Hospitals that are successfully maximizing their anesthesia reimbursement opportunities are doing the following:
- Follow up. It makes a big difference. Don’t let that stack of accounts receivables pile up. Designate a member of your team who can take the lead on working through these documents to investigate what the issues are and identify what steps need to be taken to resolve them. Sometimes unpaid bills are a result of everyday human error, such as a typo in a policy number, or a discrepancy in a mailing address. Simple fixes can often make a big difference when it comes to reimbursement.
- Manage the credentialing processes up front. Get to know your insurance carriers. Identify which ones are most likely to be presented by your patients, and enroll with these companies proactively. Read about their timeframe policies and assure that all members of your staff are clear on what needs to be done, and by when, to assure that your claims can be processed in a timely and efficient manner. This is a cumbersome, but extremely valuable process.
- Train and educate your team. Insurance systems, policies, carriers and protocols change just about every day. You can’t hire staff, orient them to their jobs, and expect them to “run with it” without ongoing education, training and critical updates from the industry, which impact the work they are doing. Make it a priority to provide your team with ongoing learning opportunities. Help them understand what the most common errors are and how they can be avoided. Teach them new processes and give them ideas for how they can manage their workload more efficiently and accurately. They will appreciate that you are investing time to help them, and will do a better job for you as a result.
- Keep those lines of communication very open. Remember, each member of your team is working on various challenges every day. Directors, managers and front-line staff can all learn from one another by engaging in open dialogue. Encourage your staff to talk about the scenarios they are encountering, the steps they took to resolve issues and what was learned from each situation. It will make every member of your team stronger and more knowledgeable.
- Audit yourself. Take a long, hard look at how things are being done and question if there are better, more efficient ways to manage internal processes, which will lead to improved anesthesia reimbursement. By investing the appropriate time and resources into a thorough internal auditing process, you can create a system that is based on doing things right the first time, rather than a system that simply exists to fix problems.
Implementing these processes takes time and a commitment from everyone involved. However, the return is well worth the effort, considering the challenging and unique nature of anesthesia reimbursement. When done correctly, these processes can go a long way in terms of optimizing the financial performance of your hospital’s anesthesia service.
About Nick Carroll and Clinical Colleagues, Inc.
Nick Carroll is President of South Care Billing, Inc., leading and managing billing operations on behalf
of hospitals that contract with Clinical Colleagues, Inc., a national provider of anesthesia practice
management services. He works collaboratively with members of Clinical Colleagues’ leadership team to
assure that each hospital client is billing and collecting appropriately for patient cases that require
anesthesia. To learn more about Clinical Colleagues, visit www.ClinicalColleagues.com.