Medical billing, coding, and collections are all essential components to keeping your anesthesia practice running smoothly. You’ve worked hard in your anesthesia practice – now how do you handle billing? Your revenue and cash flow are entirely dependent upon your billing processes and accounting understanding. It’s critical to ensure that these processes are as close to optimal as possible. The first step is to decide whether you want to complete your billing in-house or outsource your anesthesia billing and accounting to another team.


In House Anesthesia Billing:


Less expensive: Doing billing yourself can be “cheaper” than outsourcing if you have a sufficient volume of cases. Outside billers typically charge by the procedure or based on a fixed percentage of revenue. If you are paying your staff a fixed salary and have a high enough revenue base— then salaries + benefits might be lower than what a billing agency would charge.

Maintain control: Some doctors feel that they have more control over the billing process when their direct employees are doing the billing versus working with an agency that works within its own procedures.



Possibly lower revenue: Anesthesia billing is hard. It requires a significant investment in people and processes that are hard to justify if you’re billing for less than a hundred doctors. Sub-optimal investment generally results in lower total collections. We see in-house billing departments lose up to 15% of revenue from billing and collecting issues.

More hassle and risk: More control is also more responsibility. Employees must be hired, trained, and supervised. Any mistakes or problems they create become the problem of the group as a whole. There is significant liability associated not just by the usual employee issues but also by the enormous revenue and HIPAA protected data that flows through your billing operation.


Outsourcing Anesthesia Billing:


Increase revenue: The right anesthesia billing company will help you increase revenue and in turn increase profits. A strong team will have optimized processes and rigorously follow up on rejected claims over and over until they are paid in full. This alone can help you collect more on each claim and increase revenue by 5-15%.

Reduce billing errors: By using an anesthesia expert, you can feel confident that they know all the latest codes and conversion factors used in the industry. This expertise reduces the number of claims that are declined/rejected and additional insight can provide essential feedback to maximize your reimbursements.

Decrease operating costs: If you have a smaller number of cases, it doesn’t necessarily make sense to take the time, money, and resources to invest in W-2 anesthesia billing employees and the supporting systems that they require.



Higher direct costs: Depending on your situation, it might cost less in direct costs to hire employees versus paying a billing company. However, you’re trading variable costs for fixed costs—which could come back to bite you hard if there’s a downturn in business.

Less control: With someone else handling billing, you will have less direct control; however, the right biller should be able to provide you with reports so you still have clear insight into exactly how your business is running. Don’t consider doing business with a billing company that doesn’t offer full transparency.


It’s All About Investing in People, Processes, and Technology

Significant investments must be made into people, processes, and technology supporting anesthesia billing regardless of if you complete your billing in-house or if you outsource it. If you choose to insource billing you will need to make these investments directly in terms of training, updated guides, and systems. The costs built into a billing provider fees indirectly pays for these investments.

Whether your billing is in-house or outsourced— don’t underinvest in your billing systems. The “savings” will cost you many times over in terms of decreased revenues and increased risk of compliance errors.