Herndon, VA 20170
607 Herndon Pkwy Suite 101
We offer a customizable simple cost-effective approach payroll and human resources from workplace compliance to personnel screening and searches, all executed with a real-live point of contact.
About our Company
Reston Anesthesia Management Services is a medical practice management company specializing in anesthesia practices. We have been in existence for 33 years. We manage several hospitals, surgery centers and office based practices. Our unique business/practice model is structured to take advantage of current tax law and both qualified and non-qualified retirement plans.
The revenue cycle management (RCM) process in anesthesia has changed and will continue to evolve. There are no “clean claims” or “file and forget” approaches anymore. High deductibles, co-pays and escalating out-of-pocket maximums now place most of the financial burden on the patient. In addition, the increasing presence of secondary insurers add to the length of the RCM process. The back-end management of denials and commercial and personal accounts receivables has become the most important and time-consuming part of the RCM. People not software have now become the major tool for reducing Account Receivables. ARs are becoming an ever-increasing aspect of anesthesia revenues.
Small anesthesia groups need QA/QI data to satisfy their employing center’s contractual requirement and to make an honest effort in quality, safety and cost improvements. So, what is the best way to do this? If you want or need a simple QA/QI digital interface, we can build one for you. If you meet eligibility criteria to report MIPS data, then simply join the AQI
Basic formula = (Base units + Time units + Modifying units) x Conversion factor = Total Charge
The base units are determined by the difficulty of the procedure. The higher the difficulty the higher the number of base units assigned to a procedure. Base units are standardized nationally.
Time unit = The length the surgeon takes to complete the procedure. A time unit is typically 15 minutes in length, but may be 10-12 minutes depending on the location. If an anesthesia procedure takes 45 minutes, using a 15 minute time unit, this would be included in the anesthesia calculation formula as 3 time units.
Modifying unit = A modifying unit accounts for special conditions that affect the anesthesia plan and administration. Modifying factors may include a patient’s physical health or emergency situations.
Conversion factor = This is the dollar cost of each unit.
Total anesthesia charge = Once you have added the total number of units together it is multiplied by the conversion factor and the total anesthesia charge is calculated.
Surprise Medical billing occurs when patients receive care from out-of-network providers and receive a large out-of-network bill. The insurance company may pay some amount to the out-of-network provider, but typically much less than the provider’s list price (or “charge”) for the services. In such cases, the provider then “balance bills” the patient for the difference between their list price and the insurer’s payment.
Current Legislation in Congress has stalled due to a poor bill design. The current bill disallows any arbitration between the providers and insurers. The bill solely allows the insurer to determine the amount a hospital or provider will be paid. Hospitals and doctors opposed the bill due to a lack of a fair arbitration process in the bill.
Reston Anesthesia Management Services anesthesia groups use the "Anesthesia Care Team" model most of the time in their practices just as most practices throughout the country. This approach involves both a Physician Anesthesiologist and a Certified Registered Nurse Anesthetist (CRNA) providing the services. Some insurance companies, including MEDICARE require anesthesia groups to "split" and submit the anesthesia charges between the MD and CRNA. This insurance requirement is not duplicate billing. It simply divides the total anesthesia services charge between the two providers.