Frequently Asked Questions About Anesthesia Billing and Anesthesia Patients

I am a potential client and I would like to know...

• Are all the medical direction rules for insurance payers incorporated in your system?

  Yes, F1RSTAnesthesia is designed to accommodate any variation on the Medicare medical direction billing rules for CRNAs, student nurse anesthetist, residents or PAs.

• Can your billing system interface with our EMR?

  Yes, we pride ourselves on being able to interface with any electronic medical record.

• Can you help us with our hospital contract and stipend negotiations?

  We have extensive experience negotiating favorable contract terms with all manner of facilities.

• Do you attend our monthly meetings?

  Typically, an account manager or a vice-president of client services will attend your management committee or group meetings to review performance trends and answer questions.

• Do we have access to your system?

  The ABC web portal provides access to standard monthly reports, anesthesia patient ledgers and our data warehouse.

• Does your company perform periodic audits of your employees coding and how often?

  ABC employs a variety of specific audit protocols to ensure that no less than 3% of every client’s charges are audited each year.

• For a group our size, does your company provide on-site staff? If so, how many?

  ABC will routinely provide staff at the client’s location if the size of the practice and the volume of charges justify the expense.

• How can we be sure our data is secure?

  Our servers are designed to provide full redundancy in processing, which ensures there is no down-time. We also have state of the art security for all IT functions as well as off-location backup.

• How can you assure my group that money will not be lost during the transition?

  Past experience is the best predictor of future success. Our track record converting anesthesia and pain management clients from other billing solutions speaks for itself. Rarely do we see less than a 10% increase in cash collections by the third month of billing.

• How do you manage compliance?

  Maintaining each client’s compliance with governmental and commercial payer billing guidelines is a top priority. The formulation of clear, written policy manuals, the provision of provider in-service sessions and regular auditing of charges are routine aspects of this commitment to keeping our clients off the compliance radar screen.

• How does ABC monitor productivity by employee/job function?

  Every job and function is subject to constant and consistent oversight and monitoring. Over the years we have developed production and performance standards that have become the key to our consistent success.

• How does your company make sure there is a charge document generated for every service provided?

  All charges are managed according to a tight batch-control methodology that includes reconciliation to the O.R. schedule.

• How does your company verify that every payment received is the correct payment?

  Payment verification against contracted rates is an integral and real-time aspect of our proprietary billing software.

• How does your transition and implementation process work?

  We have developed a very detailed implementation process and checklist that will be reviewed with you once a contract has been signed. ABC staff will assume full responsibility for ensuring that we have captured all necessary information to bill your claims accurately and provide timely and reliable practice management information.

• How many employees do you have?

  Our staff consists of well over three hundred experienced anesthesia billing professionals.

• Once a contract for services is signed, how much time would be required to be able to bill out claims?

  Our standard implementation process is 60 days. Once we start capturing charges, claims are submitted daily.

• What are ABC’s performance standards such as days in A/R, bad debt and net collections?

  Our goal is to meet or exceed MGMA accounts receivable management performance targets.

• What are the qualifications of our account manager?

  ABC account managers are experienced anesthesia billing specialists most of whom have a minimum of ten years' experience with the company.

• What is your experience in anesthesia billing?

  ABC has been providing billing and management services exclusively to anesthesia practices and to hospitals that employ anesthesiologists and CRNAs for 30 years.

• What role would your company play in our group’s negotiations and contracting with payers?

  ABC staff have extensive experience negotiating with payers and will work with you to ensure that you receive optimum rates and terms.

• What services do you provide? (scope of services including consulting and financial management)

  ABC provides a full scope of services that addresses all aspects of revenue cycle management. Our scope of services provides specific solutions for each phase of the anesthesia billing and collections process from coding to electronic claims submission. Our practice management services address all aspects of your business from bookkeeping, to accounts payable management to compensation plan administration.

• What type of information is normally included in the monthly reports?

  Standard management reports provide snapshot and trend views of production data, performance patterns and accounts receivable metrics. Our unique approach to management information allows a practice to drill-down to the individual anesthetizing location or payer.

I am a patient and I would like to know...

What options are available to me to pay my bill?

• You can mail in your payment with your statement – statements are sent every month.
• You can call our patient’s accounts line 800-222-1442 to speak to a customer service representative who can set up payment arrangements, i.e., payment plans, take credit card payments during the hours of 8am – 7pm eastern standard time
• You can call our 800-242-1131 to make a credit card payment through our automated phone system (voice recognition system) 24 hours/7 days a week
• You can email a representative at customer.service@anesthesiallc.com

Am I eligible for any financial assistance on my anesthesia bill?

It depends on the Anesthesia group. You should contact the Customer Service Department to be advised if your group does provide financial assistance.

• Can I get a copy of my medical records from you?

  You must contact the facility where the procedure was held or your primary care physician to obtain your medical records.

• I gave my insurance information at the time of service, so why am I still getting bills requesting insurance information?

  Anesthesiologists bill separately from the hospital. Sometimes the anesthesiologist can obtain this information from hospital, however, many times the doctor is called to another facility and the information is not taken. It is for your protection that the hospitals not give out your information to random callers; there is a place provided on the back your bill for insurance information which can be mailed, faxed or e-mail to the Anesthesia Group.

• I sent a check to you over a week ago and it was cashed, but I still got a bill this month. Why?

  It can take up to 30 days for your payment to post to your account. The statement cycle probably crossed in the mail. If you provide the check number, check date, payment amount and date it cleared your bank we can trace your payment to ensure it posts to your account.

• I tried using your automated phone system but it didn’t work for me. Why?

  You must have the account number in order to access your account information. Account numbers are 8 digits long and can be located in the yellow box on the top right-hand side of your statement.

• My explanation of benefits states that I am not responsible for the transfer amount showing on my bill so why am I being billed this additional amount?

  It could be an issue where we are not contracted with your insurance company, but the only way to be clear is for us to review your EOB.

• Why am I being billed for two anesthesia providers when I only had one in the room with me?

  You had what is called “Team Anesthesia,” where one provider was the anesthesiologist and the other was a Certified Registered Nurse Anesthetist (CRNA). Both the anesthesiologist and CRNA shared in caring for the patient, allowing both to bill for their services.

• Why is my insurance participating with the facility but not with the anesthesiologist?

  The anesthesia group is a separate entity from the facility, and therefore, participation with insurance payors may be different than the insurance payors the facility is participating with.

• Why did it take so long for me to receive a bill after my procedure?

  We do not bill the anesthesia patient until the claim has been fully processed by your insurance company.

• Why did my insurance not pay more on the claim?

  That is something that you would have to discuss with your insurance company. We are billing what the insurance company has advised based on your insurance policy.