ClainetRCM delivers end-to-end revenue cycle management built for anesthesiologists, CRNAs, anesthesia groups, and ambulatory surgery centers. Stop losing revenue to miscounted time units, wrong provider modifiers, and medical direction gaps.
Anesthesia is the only specialty where reimbursement depends on base units, documented minutes, who was in the room, and how many cases they were covering at the same time. A rounded start time or a wrong modifier changes what the payer owes on every single case.
AAPC Certified coders recalculate base and time units from the anesthesia record and match the provider modifier to documented concurrency before the claim goes out
Every Case Recalculated Before Submission
Every anesthesia code from 00100 to 01999 carries a base unit value, and time units are added from documented start and stop times. We verify the surgical CPT crosswalk and count minutes exactly as each payer requires, so discontinuous and relief time is never lost.
AA, QK, QY, QX, QZ and AD tell the payer who delivered the anesthesia and at what concurrency. The wrong one triggers denials, 50 percent underpayments, and audit exposure. We match the modifier to the anesthesia record on every claim.
A medically directed case is only payable when all seven direction steps are documented and the anesthesiologist stays within concurrency limits. We check the record before billing and flag cases that should be billed as supervision instead.
P3 to P5 modifiers and codes 99100, 99116, 99135 and 99140 add units on most commercial contracts but are ignored by Medicare. We know which payers pay for them and bill them where they count.
From the anesthesia record to final payment posting, ClainetRCM manages every step of your anesthesia revenue cycle so your providers can stay in the OR.
Complete billing management built specifically for anesthesia groups, CRNAs, surgery centers, and hospital anesthesia departments.
Certified coders with deep anesthesia coding expertise capture every case at the correct, compliant unit value.
Fast payer enrollment and re-credentialing for anesthesiologists, CRNAs, and anesthesiologist assistants so no case goes unpaid for a lapsed credential.
Dedicated remote assistants to absorb the pre-operative and pain clinic workload that slows anesthesia groups down.
Dedicated AR follow-up to recover outstanding anesthesia claims and pull down aging balances across every payer.
A thorough audit of your anesthesia billing to surface revenue leakage and compliance risk before it escalates.
Anesthesia groups face billing obstacles that generic billing companies consistently get wrong. We know them all, and we fix them.
Start and stop times rounded to the quarter hour or left off the record cost a time unit on every case. We reconcile anesthesia times against OR logs before billing.
Billing AA when a CRNA was involved, or QZ in a directed case, produces denials and recoupments. We match every modifier to the documented staffing.
An anesthesiologist directing a fifth case at the same time drops every case to supervision rates. We check overlap across all cases before assigning QK.
Peripheral nerve blocks placed for post-operative pain at the surgeon's request are separately payable and routinely missed. We capture them with the correct modifier.
Payers quietly pay below the contracted conversion factor. We calculate the expected allowable on every case and appeal every short payment.
P3 to P5 modifiers and qualifying circumstances add paid units on commercial claims but are often left off or billed to Medicare. We bill them only where they pay.
Labor epidural billing rules for time, caps, and cesarean add-on codes differ by payer. We apply each payer's method so obstetric anesthesia is paid in full.
Cases that make it onto the OR schedule but never reach a claim are pure lost revenue. We reconcile the surgical schedule against billed cases every cycle.
Onboarding with ClainetRCM is fast and seamless. Most anesthesia groups go live within one week with no disruption to the OR schedule.
We recalculate a sample of your cases and identify anesthesia revenue gaps at zero cost.
We connect to your billing platform or anesthesia record system and load every payer conversion factor.
A dedicated billing team with real anesthesia experience is assigned immediately.
Clean, correctly modified claims submitted within 48 hours of case close with real-time tracking.
Watch collections per unit climb with transparent monthly performance reporting.
These are the standards we control and hold ourselves to, written into every engagement.
Whether you are an independent CRNA or a multi-facility anesthesia group, ClainetRCM delivers billing that scales with your case volume.
Care team practices and ambulatory surgery centers looking to cut denial rates, capture every unit, and shorten AR across every facility they cover.
Hospital anesthesia departments needing enterprise reporting, concurrency compliance oversight, and clean reconciliation between the OR schedule and billed cases.
Solo anesthesiologists and independently practicing CRNAs who need accurate AA and QZ billing without hiring in-house staff.
Anesthesia is paid on a formula rather than a flat fee per code. Each anesthesia CPT code from 00100 to 01999 carries a base unit value for the complexity of the procedure. Time units are added from the documented anesthesia start and stop times, with most payers counting one unit per 15 minutes. Physical status and qualifying circumstance units are added where the payer recognizes them. The total is multiplied by that payer's anesthesia conversion factor. We calculate the expected allowable for every case and compare it to the remittance.
We apply AA for cases personally performed by an anesthesiologist, QK for medical direction of two to four concurrent cases, QY for medical direction of one CRNA, QX for a CRNA working under medical direction, QZ for a CRNA working without medical direction and AD for supervision of more than four cases. We also apply P1 to P6 physical status modifiers, QS, G8 and G9 for monitored anesthesia care, and modifier 23 for unusual anesthesia, and we verify concurrency so the modifier matches the documented staffing on every case.
Yes. On medically directed cases we submit one claim for the anesthesiologist with QK or QY and one for the CRNA with QX, and each is paid at 50 percent of the allowable. On independent CRNA cases we bill with QZ at the full allowable where the payer permits. We confirm all seven medical direction steps are documented before a directed claim goes out, because missing steps are a common audit finding.
Yes. Many anesthesia groups also run a pain practice. We code and bill epidural steroid injections, facet and medial branch blocks, radiofrequency ablation, spinal cord stimulator trials and implants, peripheral nerve blocks and the related E/M visits, and our virtual assistants manage the prior authorizations most payers require for interventional pain procedures.
ClainetRCM works with the platforms anesthesia groups already use, including Epic, Cerner, Plexus TG, AdvancedMD, Athenahealth, eClinicalWorks, Kareo and anesthesia information management systems that export case data. We adapt to your existing technology rather than forcing a migration, so onboarding does not disrupt your OR schedule.
Pricing starts at 2.29% of monthly collections, so we are only paid when your group is paid. There are no setup fees, no long-term contracts, and no hidden charges. Book a free consultation for a quote based on your case volume, provider mix and payer mix.
Talk to an anesthesia billing specialist about your collections per unit, your modifier accuracy, and your AR aging.
No obligation. Our anesthesia billing specialists will review your current setup and identify exactly where you are losing revenue.
In a single free session, our anesthesia RCM experts will recalculate a sample of your cases, uncover hidden billing gaps, and give you a clear roadmap to increase collections starting immediately.
Send us 90 days of remittance data and we will show you, line by line, which claims were underpaid, denied, or never worked, and what it would take to recover them. No cost, no obligation, and you keep the report either way.
No setup fee. No long-term contract. Pricing from 2.29% of monthly collections.
