Medientsky Billing took up the case and analyzed the physical EOBs that he had been receiving from his billing company over the past one year and also studied the patient demographics over the same period of time. We immediately found a pattern; the cases he attended to were usually the elderly with mild or severe systemic diseases. Our experienced coders sensed that the low reimbursements could have possibly been due to wrong physical status modifiers being utilized by the other service. We gave forth our findings and the anesthesiologist was happy enough to let us don the biller’s role. The above analysis stood confirmed when in the forthcoming months his average earnings doubled after working with us. We were using the modifier P3 (A patient with severe systemic disease) a lot for his claims and knew that if his service in Rutland had been using P2 (A patient with mild systemic disease); there could have been a considerable difference in the reimbursement rates. It is easily possible for someone not that well-versed in Anesthesia Coding to classify conditions such as “poorly controlled hypertension” or “morbid obesity” with the modifier P2. The higher reimbursement when you transition from P2 to P3 is due to the fact that there are a lot of risk factors associated with treating these patients, and there is considerably a lot more effort involved in making sure these patients survive a surgery. The insurance companies know this.