How Medientsky Billing Helped an Underpaid Anesthesiology Practice Increase Cash Flow

Discover how our specialists resolved major billing issues for a Vermont anesthesiologist, doubling collections by correcting coding and enhancing claim processes.

Table of Contents

Introduction

An anesthesiologist practicing in the Green Mountains region of Vermont was struggling with consistently low collections despite the time and effort invested in his practice. Unhappy with his existing billing service, Jason contacted Medientsky Billing to determine why his reimbursements from insurance companies and other payers had remained so low over the previous year. Before taking over the billing process, Medientsky Billing first analyzed the practice’s existing revenue cycle. The goal was to identify the reasons behind the underpayments and determine whether issues with coding and claim processing were affecting reimbursement. The analysis revealed a pattern in the practice’s patient population and raised concerns about the use of physical status modifiers in anesthesia claims. After reviewing the findings, Jason decided to allow Medientsky Billing to take over his billing responsibilities. The results were significant. His average earnings doubled after working with Medientsky Billing.

The Backstory: A Practice Struggling With Low Collections

Jason was an anesthesiologist practicing in a relatively isolated area of Vermont. He had been using a small medical billing company in Rutland to manage his billing. However, he was increasingly dissatisfied with his collections. As he explained to Medientsky Billing:

“I’m not happy with my collections. It remains abysmal no matter how many hours I work.”

The challenge was not simply the amount of work involved in running the practice. Jason wanted to understand why the services he was providing were not generating the reimbursement he expected from various insurance companies and payers. Because of his location and limited access to modern conveniences, much of the communication and exchange of patient information with his existing billing service was handled manually. Patient demographics and other information were routinely couriered to the billing company or communicated by phone. Before accepting responsibility for the billing process, Medientsky Billing agreed to investigate the underlying revenue cycle issues.

Analysis of Jason's Revenue Cycle

Medientsky Billing reviewed the physical Explanation of Benefits (EOBs) that Jason had received from his billing company over the previous one-year period. The team also reviewed patient demographic information from the same period to identify patterns that could help explain the low reimbursements. During the analysis, Medientsky Billing identified a recurring pattern in the types of patients being treated. Many of the cases involved elderly patients with mild or severe systemic diseases. This prompted the experienced coding team to examine whether the physical status modifiers being used on the anesthesia claims were accurately reflecting the documented patient conditions. The review raised concerns that the existing billing service may have been using the wrong physical status modifiers in some cases.

Understanding the P2 and P3 Modifiers

According to the case study, Medientsky Billing identified the use of P3, which represents a patient with severe systemic disease, as an important factor in the practice’s reimbursement analysis. The team believed that the previous billing service may have been using P2, representing a patient with mild systemic disease, in situations where P3 could have been applicable based on the patient’s documented condition. The case study specifically points to conditions such as:

  • Poorly controlled hypertension
  • Morbid obesity

These types of cases can be more complex from an anesthesia perspective because of the systemic conditions and associated risks involved in treating the patient. The distinction between P2 and P3 therefore became an important part of the revenue cycle analysis. The Medientsky Billing team determined that the use of P3 was appropriate for a significant portion of the claims they reviewed and that incorrect modifier selection could have contributed to lower reimbursement. Rather than simply processing claims as they had been handled previously, the team examined the underlying coding and patient information to determine whether the claims accurately represented the services and patient conditions documented in the records.

From Revenue Cycle Analysis to Billing Support

Once Medientsky Billing presented its findings, Jason was satisfied with the analysis and decided to allow the company to take over his billing responsibilities. The initial review provided a clearer understanding of where the practice’s reimbursement process was falling short. The focus then shifted toward applying the findings to the ongoing billing process. By paying closer attention to anesthesia coding and the appropriate use of physical status modifiers, Medientsky Billing worked to ensure that claims were being submitted with the relevant information identified through the revenue cycle analysis. The impact became apparent in the following months. Jason’s average earnings doubled after beginning to work with Medientsky Billing. This improvement reinforced the importance of examining the details behind a practice’s reimbursement performance rather than simply accepting low collections as a normal part of the billing process.

A Billing Partner Who Understood the Practice

For Jason, the experience was about more than an increase in collections. He had been looking for a billing partner who could understand the specific requirements of his practice and identify why his existing billing process was not producing the results he expected. After reviewing his revenue cycle and addressing the coding issues identified during the analysis, Jason expressed his satisfaction with the new billing relationship.

Testimonial

“I think I’ve finally found the right biller”

Jason further described his experience:

“Running from pillar to post looking for a biller who understood my needs, I’ve finally found the best solution. It shocked me that I was being repeatedly underpaid all these years. I’m really happy with your services.”

The testimonial reflects the central issue identified in the case study: the practice needed a billing partner capable of looking beyond routine claim submission and examining the reasons behind its reimbursement performance.

Actionable Financial Data in a Few Taps

Medientsky Billing also introduced Jason to its real-time financial KPI reporting app. The app provided analytical reports that helped Jason track his claims cycle and monitor important revenue cycle information. The reporting included detailed information related to:

  • Collection KPIs
  • Charge capture KPIs
  • Claims cycle performance
  • Revenue cycle activity

Having access to this information gave Jason greater visibility into the financial performance of his practice. Instead of relying solely on the results of individual claims or periodic billing updates, the reporting system provided a way to review key revenue cycle indicators and better understand the practice’s financial performance.

Why Anesthesia Coding Accuracy Matters

This case study highlights how coding details can affect reimbursement in an anesthesiology practice. Anesthesia billing involves specific coding requirements, including the use of physical status modifiers to describe a patient’s condition. When the documentation and coding do not accurately reflect the patient’s documented condition, reimbursement may be affected. In Jason’s case, the revenue cycle analysis focused specifically on the difference between P2 and P3 modifiers and whether the existing billing process was accurately representing the patient population being treated. The analysis allowed Medientsky Billing to identify a potential source of underpayment and address it as part of the practice’s billing process.

The Importance of Revenue Cycle Analysis

Low collections do not always indicate that a practice lacks patients, performs too few procedures, or needs to increase its workload. Sometimes, the underlying issue can be found within the revenue cycle itself. Jason’s experience demonstrates the value of examining:

  • Existing EOBs
  • Patient demographics
  • Coding patterns
  • Physical status modifiers
  • Claim processing
  • Collection performance
  • Charge capture data

A detailed review of these areas can help identify patterns that may otherwise remain hidden within routine billing operations. For this anesthesiology practice, the analysis uncovered a potential coding issue that helped explain why reimbursement had remained below expectations.

Results

The partnership between Jason and Medientsky Billing resulted in a clear improvement in the practice’s financial performance.

Average Earnings Doubled

The most significant result reported in the case study was that Jason’s average earnings doubled after working with Medientsky Billing.

Coding and Claim Processes Reviewed

The revenue cycle analysis identified concerns related to physical status modifier usage and helped address the way claims were being coded and processed.

Greater Financial Visibility

Through the real-time financial KPI reporting app, Jason was able to access analytical information related to collection and charge capture performance.

A More Suitable Billing Partnership

Beyond the financial improvement, Jason found a billing partner that he felt understood his practice’s specific needs and the complexities associated with anesthesia billing.

Conclusion

Jason’s experience shows how a detailed revenue cycle review can uncover issues that may be contributing to underpayment. Rather than immediately taking over the billing process, Medientsky Billing first examined the practice’s EOBs and patient demographics from the previous year. This analysis identified a pattern involving anesthesia coding and physical status modifiers that could have contributed to lower reimbursement. After Medientsky Billing took over the billing responsibilities, Jason’s average earnings doubled. The case also demonstrates the value of financial visibility. Through Medientsky Billing’s real-time KPI reporting app, Jason was able to track claims cycle activity and review collection and charge capture information. For an anesthesiology practice experiencing persistent reimbursement challenges, reviewing the details behind its claims, coding, and revenue cycle performance can provide important insight into where financial opportunities may be being missed.

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