Audit your anesthesia biller in 90 days
Before you switch, measure. Pull 90 days of claims and answer these questions. If your current company cannot produce the file, that is the audit. ClearBilling will do this work with you if you want a second set of eyes. USA-based, woman-owned, anesthesia only.
Pull this file
Every claim for 90 days: DOS, CPT, modifiers, units, billed, allowed, paid, contractual, denial codes, rendering NPI, payer. Plus open A/R. Plus a credentialing roster.
Checks that find real money
Modifier mix: is QZ showing up as QX? Are MAC cases missing QS? Time units vs chart times on a sample of 20 cases. P3+ commercial cases missing physical status. Labor epidurals on a single methodology. Conversion factor: expected vs paid on your top five commercials. Providers with paid-at-zero for 'not enrolled.' Days in A/R over 90 that have no appeal note. MIPS: who is eligible, who submitted last year, and whether anyone is walking into the 9% Medicare hit.
What 'good' looks like
Not a slogan NCR. A biller who can explain every outlier in that file. If they send a dashboard and cannot speak to a single QZ vs QS issue, you have reporting, not anesthesia billing.
FAQ
Straight answers for practices comparing anesthesia billing companies.
Will ClearBilling audit us if we are not clients yet?
Bring the 90-day file to a call. We will tell you what we see. That is how we start most takeovers.
What if the old company will not export?
You should have portal access. If you do not, that is a contract and operations failure. Demand the file. We can also rebuild from payer portals and your EHR while that fight happens.
Related
We are a small, dedicated team that works incredibly hard for every penny of your revenue. If you want serious billing capability with real people who answer email, let's connect.