The whole cycle, in plain terms
- Case capture. Every anesthetic gets into the billing system, with nothing lost between the facility and us.
- Eligibility and demographics. The patient's insurance is checked so the claim goes to the right place.
- Coding. ASA code, time, physical status, modifiers and qualifying circumstances taken from the record.
- Claim scrubbing and submission. Errors caught before the payer sees them.
- Payment posting. Each payment matched to the claim and compared with what you should have been paid.
- Denials and follow-up. Every unpaid claim chased until it's paid or there's a clear reason it won't be.
- Reporting. A monthly scorecard so you can see the whole cycle at a glance.
Where anesthesia groups lose money
In our experience the leaks are rarely dramatic. A few minutes of time not captured on each case. A physical status modifier left off. A payer quietly paying below contract. Old denials nobody had time for. On their own they look small. Over a year they add up.
Our guide on signs your billing is costing you money walks through what to look for.
What you should expect to see
At a minimum: net collection rate, days in A/R, denial rate and the age of unpaid claims. If you aren't getting those from your biller today, read what your billing report should show.
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