Let’s look at each of these factors in turn:
1. The duration of anesthesia care
The total bill amount of an anesthesia bill depends largely on the duration of the anesthesia service, which depends on the duration of the surgery itself.
How duration effects your bill
A “Unit” is a 15-minute length of time of anesthesia service.
Every anesthesia company assigns a monetary value to an anesthesia “Unit.”
Anesthesia provider bills are calculated by a simple formula: (Number of Base Units PLUS Number of Time Units) TIMES the dollar value of a Unit EQUALS Total Bill Amount
The Anesthesia Timeline
Anesthesia time begins when the anesthesia provider starts attending to the patient in the pre-operative area and ends when the anesthesia provider transfers care to the post-operative nurse following the surgery.
For most surgeries, a typical timeline involves:
- 10-15 minutes of anesthesia exam in the pre-operative area,
- 5 minutes of time transporting the patient to the operating room,
- 5-10 minutes time inducing anesthesia,
- 10–40 minutes of time positioning, prepping, and draping the patient,
- the entire surgical duration,
- 5-15 minutes of time to wake the patient up,
- 5-10 minutes of time to transport the patient to the Recovery area, &
- 5-10 minutes’ time to sign the patient over to the nurse’s care in the Recovery area
Even though the anesthesia billing time concludes when the patient’s care is signed over to the PACU nurse, the anesthetist oversees the patient’s comfort and care during Recovery. This includes monitoring vital signs, pain control, nausea therapy, and the timing of the patient’s discharge.
2. The complexity of the scheduled surgical procedure
The Base Unit value for any anesthetic varies with the complexity of the scheduled surgery. The Base Unit value reflects the degree of work and risk involved in the anesthetic management for each type of surgery.
3. The insurance status of the patient
The United States government sets a cap on how much Medicare and Medicaid patients can be billed. The dollar value per anesthesia Unit is severely discounted for Medicare and Medicaid patients to a number as low as one-fourth to one-fifth the amount a non-Medicare or Medicaid patient is billed.
📌A NOTE REGARDING COSMETIC & DENTAL SURGERY:
Insurance companies do not pay for plastic surgeries such as liposuction, breast implants, or facelifts. They often do not cover IV sedation for Periodontal or Oral surgery. Patients must pay the surgeon, operating room, and anesthesia bills in advance.
