Avoiding Anesthesia Billing & Compliance Pitfalls: Lessons from a $532K Oklahoma Settlement

In July 2025, the Oklahoma Attorney General’s Office announced a $532,055.76 settlement with a dental practice accused of submitting improper claims to the state’s Medicaid program. According to the public release, the allegations involved inflated anesthesia time units, double-billed patient encounters, and billed for tobacco cessation counseling for patients who did not smoke.

This case, while specific to one provider, highlights a broader challenge facing anesthesia groups, ASCs, and billing teams nationwide: the smallest documentation gaps can create massive compliance and financial risks.

Why This Matters for Anesthesia Providers and Billers

Anesthesia billing is uniquely complex because it combines time-based units, CMS quality reporting, and payer-specific documentation requirements. Even a minor oversight—like rounding times incorrectly, billing for counseling without proof it occurred, or failing to maintain proper records—can put providers and facilities under scrutiny.

The key takeaway isn’t fear—it’s prevention.

The right processes, combined with the right technology, can help practices avoid falling into these traps.

Five Essential Practices to Reduce Billing and Compliance Risks

1. Document Exact Start and Stop Times

Anesthesia time should reflect precisely when anesthesia care begins and ends—not when the patient is in pre-op or PACU. Avoid rounding up or estimating; automated solutions can capture exact times and eliminate human error.

2. Support CMS Quality Measures with Real Evidence

Measures like smoking cessation counseling, perioperative temperature management, or timely antibiotic administration require verifiable documentation. A checked box in the EMR isn’t enough—you need:

• Patient status (e.g., smoker or non-smoker),
• Details of the counseling or intervention provided,
• The provider who performed it and when.

3. Audit Proactively, Not Reactively

Waiting for an audit notice to review your records is too late. Instead, set up internal audits—monthly or quarterly—to catch discrepancies early and protect against recoupments.

4. Train Staff and Providers Continuously

Billing rules evolve, payer policies shift, and CMS updates measures frequently. Make compliance education part of your culture so that every provider, scheduler, and biller understands their role in accuracy.

5. Leverage Technology for Built-In Compliance

Manual processes create gaps.  A platform like Waizant™ integrates billing, documentation, and CMS quality reporting into a seamless workflow—reducing the chance for human error while ensuring every claim is defensible.

How Waizant™ Simplifies Compliance

At Waizant™, we recognize compliance must be embedded—not bolted on. Our SaaS platform empowers teams by:

• Automating anesthesia time capture to the second.
• Prompt providers in real-time to document CMS quality measures before a claim goes out.
• Flag missing or inconsistent data before submission.
• Generate audit-ready reports for compliance teams and administrators.

By embedding compliance checkpoints directly into the workflow, Waizant™ helps teams minimize errors, reduce denials, and protect revenue integrity.

Final Thoughts

The Oklahoma settlement isn’t about one dentist—it’s a cautionary tale for the entire perioperative community. Inaccurate billing doesn’t always stem from fraud; more often, it comes from process failures, documentation gaps, or outdated workflows.

Smart tools and strong compliance habits can transform billing accuracy and protect organizations from costly mistakes, while improving efficiency and patient care.

If you want to see how Waizant™ can help your team stay compliant without adding more work, request a demo today!