News & Articles

"BUT, WE BILLED THE INSURANCE CARRIER"

By Leigh Perry

For an anesthesiologist, it isn't just a matter of sending in a bill to an insurance carrier and waiting to be paid. For a carrier to pay an anesthesia bill, properly or at all, they must first receive the surgeon's bill and, if applicable the facility bill. This is why follow up is so important. An anesthesia biller needs to contact a carrier either by telephone or, if possible via the internet. If it is discovered that have made a nominal payment or are pending payment altogether since they are waiting for the surgeon and or facility bill, the anesthesia biller needs to get in contact with the offices involved in those billings to make certain that they have sent a claim to the carrier.

It is important to remember that just because a bill has been sent it does not mean that the carrier has received it. So often, I will call one of these offices and they will tell me that they have already billed the carrier. My next question to them is "Have you been paid?" If they have, I ask for whatever information they can give me about the payment. If they have not, I ask them to please rebill the carrier. Sometimes I get resistance, but I do my best to convince them to re-bill, as much for their sake as for my anesthesiologist.

There are also occasions where the surgeon is non-participating and has been paid up front for a service, leaving the carrier billing to the patient. This is the most frustrating situation of all because patients are surprisingly lax in billing their insurance carrier, even though it means they will be reimbursed for money they have paid the doctor. I will do all I can to convince the surgeon's office to send in a paid bill to the carrier since my provider's payment absolutely hinges on the carrier getting this bill.

As you can see, an anesthesiologist billing for themselves has double and triple work to do in order to get their claims paid. If they place their accounts in a low budget billing company there is no guarantee that this company will put forth the extra effort required to get the anesthesia bill settled. If proper follow up is not done by the surgeon's biller, as is the case more often than I can say, than it rests in the hands of the anesthesia biller to make the discovery and then connect with the surgeon's biller in order to get BOTH their claims paid. This is why an anesthesiologist needs an earnest, effective biller in order to get his or her claims settled properly.

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