anaesthetic billing service
The Anaesthetist’s ‘Second Shift’
Reclaiming Your Time from Admin Overload
Author: Ben Dudley
Date: August 27, 2025
The theatre lights dim, your final case is done, and you’ve completed another busy day of clinical practice. But for many anaesthetists in private practice, as you head home, a different kind of challenge awaits. Your real work may be done, but a hidden ‘second shift’ is just beginning.
This is the lived experience that was the very foundation of Zento. Our founder, Ben Dudley, saw it firsthand with his wife, an anaesthetist starting in private practice.
“The medicine was good, the working was good… but bringing everything home and then having to think about it, that was just added load, added complexity, added frustration. Having done a full day of work, we then needed to spend four hours in the evening doing the billing for that work. It was like she was learning her medicine all over again.”
Ben Dudley
Founder and Managing Director
This is the anaesthetist’s ‘second shift’, and its true cost goes far beyond a few lost hours in the evening.
anaesthetic billing service
What is the ‘Second Shift’? The Mountain of Hidden Tasks
The administrative burden on an anaesthetist in private practice is far more than just “doing the billing.” It can be an overwhelming list of tasks, each demanding time, focus, and a specific skill set that medical school simply doesn’t teach.
“When you do your training program, it’s about your specialty… It doesn’t teach you about how to submit a Medicare claim or what the gap schemes are. Suddenly, you’re expected to know all that.”
This ‘second shift’ includes:
- Issuing and tracking Informed Financial Consents (IFCs).
- Sending and managing pre-operative patient questionnaires.
- Securing out-of-pocket payments and pre-authorisations.
- The actual billing, navigating a maze of codes and rules and ensuring claims are successfully submitted via ECLIPSE.
- Chasing down rejections and unpaid claims from Medicare, health funds and third parties.
- Handling post-operative patient surveys and feedback.
For a solo practitioner, the complexity can become too much. As one anaesthetist juggling private work across multiple Brisbane dental clinics noted, “As it gets busier, the volume of patients starts to get a little bit overwhelming. I’m at that junction where I should probably get myself organised.”
This feeling is common. The ‘second shift’ grows in direct proportion to your private practice, often creating a frustrating bottleneck.
The Fork in the Road: A Tool, a Group, or a True Service?
Faced with these challenges, most anaesthetists seek a solution. The path they choose can determine whether they solve the problem or simply trade one set of frustrations for another.
The Software Tool & DIY
Many start by adopting a software tool—an app or platform promising to streamline billing. For a new fellow who is just “starting some ad hoc work,” this can seem like a perfect fit. And initially, it often works. But as the practice grows, a painful realisation dawns: a tool gives you a more efficient hammer, but you still have to know how to use it and do all the work. You are the one troubleshooting, you are the one chasing rejections, and you are the one fielding patient calls.
The Traditional Group or Outsourced Service
The next step is usually to join a traditional anaesthetic group or engage a “full-service” billing provider. However, many anaesthetists discover this path comes with its own pitfalls. In a group, as Ben points out, “people running that group are balancing competing priorities of running their own practice with running the group.” Your needs may not always be the primary focus.
Even with a dedicated billing service, the problem can persist. The reason why some services and billing providers fail their doctors is that they also become overwhelmed when their workload grows. They lose oversight, and if they don’t have a solid process and system in place, things get out of hand, despite the best intentions of delivering a great service.
The result is the ultimate frustration: you pay for a service, yet you still have to do the chasing.
I don’t have a way of tracking my billings. All I have is lots of scan papers… I have to go through them and reconcile them once they’re paid off. I just went through my invoices and I’ve got probably 40 unpaid bills… some of them date back to July and August last year.
– Established Anaesthetist, Sydney
This experience is repeated by many of the practitioners we speak to, who find themselves trapped in opaque systems where they feel a major lack of accountability. As another anaesthetist described it: “It’s just a paper trough, it just gets lost. There’s no accountability. I just want to be able to follow up where the bloody hell the money is and where it’s going.”
The Hidden Risk
Your Professional Responsibility
The stakes are higher than just lost income and wasted time. Incorrect setup or inaccurate billing can have serious consequences. Sometimes, health insurers won’t back-pay for work done before you are correctly registered in their scheme, meaning that work is “essentially unpaid.”
Even more critically, as Ben warns, “if you are not getting paid, you might not even be insured for that work. Your MDO may not cover you… because you’re no longer actually in a commercial arrangement.” Ultimately, you are responsible for every claim, and errors can trigger stressful audits.
The Real Solution
A System That Scales With You
The solution isn’t about working harder. It’s about implementing a complete system designed to liberate you from the ‘second shift’ entirely—one that seamlessly combines smart technology with the support of a dedicated human team. Your administrative partner must be 100% aligned with your success.
At Zento, we built our service on this principle. We are not just an app; we are your complete administrative team, powered by our own proprietary technology, the Zentobox.
We Absorb the Full Workload
From sending pre-op questionnaires and IFCs to handling patient phone calls and securing pre-payments, our teams manage the entire workflow. You simply focus on your clinical work.
anaesthetic billing service
Expertise Where It Counts
As Ben explains our model: “If you imagine that almost 80 percent of inquiries, questions, situations are largely routine. Once the system can handle that body of work, it frees up the team members’ time to focus on the 20 percent of complicated ones.” Our automated systems handle the high volume, freeing our experienced team to resolve complex claim rejections and manage difficult cases.
anaesthetic billing service
Control Without the Responsibility
Our process ensures you have the final say. All accounts are sent to you for approval via the Zentobox app before submission. This gives you complete transparency and peace of mind.
“People feel that to be in control, they need to be doing the things. Whereas I say to be in control, that’s different… By working with Zento, you don’t have to take responsibility for implementing those decisions. You can advise us how you want things done and then we will do that.”
Ben Dudley
Founder and Managing Director
The ‘second shift’ is a choice, not a requirement. Your expertise is your most valuable asset. It should be focused on your patients, not lost to administrative stress. At Zento, we provide the system, the technology, and the team to ensure your time in theatre is your only shift.
Ready to end your ‘second shift’ for good?
Discover how Zento’s dedicated support for anaesthetists can transform your practice.