Bloggers
Tony Mira
Tony Mira founded MiraMed Global Services, Inc. in 2005 and serves as its President and Chief Executive Officer. Mr. Mira also Co-Founded MiraMed's subsidiary Anesthesia Business Consultants, LLC in March 2001 and serves as its President and Chief Executive Officer.
By bringing these companies together under the MiraMed moniker, he has formed one of the largest healthcare Business Process Outsourcing (BPO) companies in the United States.
By bringing these companies together under the MiraMed moniker, he has formed one of the largest healthcare Business Process Outsourcing (BPO) companies in the United States.
Recent Posts
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Robo-Anesthesia?
With remarkable timing, news of a lawsuit brought by the parents of a teenager left in a permanent vegetative state after a routine endoscopy coincides with the announcement that the Food and Drug Administration (FDA) has granted Premarket Approval for the SEDASYS® system, a computer-assisted personalized sedation system. The patient was ...May 20 -
Anesthesia Practices Can File Claims for Repayment under MasterCard and Visa Class Action Settlement
Anesthesia practices that accept Visa and MasterCard payments are among the “merchants” that may be able to collect a portion of the fees paid to the card issuers under the proposed settlement in the Payment Card Interchange Fee and Merchant Discount Antitrust Litigation pending in federal District Court in New York. The clas ...May 15 -
When is an Anesthesiologist “Immediately Available?”
Astonishingly, after decades of discussion, there is still a lot of uncertainty as to what the anesthesia medical direction rules mean by the requirement that the medically-directing anesthesiologist be “immediately available.”There has never been a numerical time or distance limit for “immediately available,” although there was a substantial debat ...May 13 -
Anesthesiologist Compensation
What do orthopedic surgery, cardiology, radiology, gastroenterology and urology have in common? Compensation in all five specialties is higher, on average, than it is for anesthesiology, according to Medscape’s Physician Compensation Report: 2013. Anesthesiology has slipped from fourth place to sixth place among the most highly-com ...May 06 -
Insights for Anesthesiologists: Participating in Hospitals’ New Strategies
The American Hospital Association (AHA) has just released a report that describes the strategies that will help its nearly 5,000 member hospitals succeed in the value-based healthcare environment. This report, Metrics for the Second Curve of Health Care, will be of interest to all anesthesiologists who want to understand and meet their h ...Apr 29 -
Other entries by Tony Mira
Richard P. Dutton, MD, MBA
Richard P. Dutton, MD, MBA is Visiting Professor of Anesthesiology, University of Maryland School of Medicine and AQI Executive Director. To contact Dr. Dutton or the AQI, visit www.aqihq.org
Recent Posts
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Why You Need a Quality Management Program
The Anesthesia Quality Institute (AQI) is a non-profit corporation created to improve outcomes in anesthesia, based on aggregating, analyzing and reporting electronic data. Over the past three years AQI has recruited more than 220 anesthesia practices, from 44 states, to contribute data to the National Anesthesia Clinical Outcomes Regis ...Feb 08 -
The AQI: Present and Future
The Anesthesia Quality Institute was chartered in 2009, and it began collecting case data in the National Anesthesia Clinical Outcome Registry (NACOR) on January 1, 2010. NACOR was designed to harness the power of the Information Age by aggregating and analyzing large quantities of data. Unlike traditional registries that depend on a trained abstra ...Sep 27 -
Puttin’ on AIRS
The Anesthesia Quality Institute was founded to create and maintain the National Anesthesia Clinical Outcomes Registry (NACOR). This project is now two and a half years old and more than 135 practices, including nine ABC clients, have contributed more than 5 million records to this “every case, every day” registry. Participants have online access t ...Aug 16 -
The AQI: Present and Future
The Anesthesia Quality Institute was chartered in 2009, and it began collecting case data in the National Anesthesia Clinical Outcome Registry (NACOR) on January 1, 2010. NACOR was designed to harness the power of the Information Age by aggregating and analyzing large quantities of data. Unlike traditional registries that depend on a trained abstra ...May 02 -
Turning Data into Dollars: How To use Quality Management information To Create Value for your Practice
The Anesthesia Quality Institute (AQI) was founded in 2009 to promote patient safety and quality management efforts across the specialty. The primary mission of the AQI is development of the National Anesthesia Clinical Outcomes Registry (NACOR), a repository for anesthesia case-specific data from across the country. NACOR is populated by transmiss ...Mar 16 -
Other entries by Richard P. Dutton, MD, MBA
Bart Edwards, MBA, MHS
Bart Edwards, MBA, MHS serves as Vice President of Client Services for ABC clients in the Eastern US. After receiving an MBA and MHS from the University of Florida, Mr. Edwards spent twelve years providing management expertise to hospital based physician practices. Since joining ABC, he has worked with anesthesia practices to demonstrate their value in and outside the operating room. Mr. Edwards gratefully acknowleges the expertise shared by Al Patin of Parish Management Consultants in this article. He can be reached at bart.edwards@anesthesiallc.com.
Recent Posts
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Anesthesia Leadership in the Preoperative Clinic
Anesthesia practices looking to optimize their value proposition at their respective facilities have sought a greater role in the preoperative preparation of their patients. The emphasis on efficiency and the continuity of care in recently suggested models of healthcare reimbursement, including Accountable Care Organizations, have drawn renewed att ...Feb 01 -
Other entries by Bart Edwards, MBA, MHS
Fred E. Shapiro, D.O.
Fred E. Shapiro, DO, is Assistant Professor of Anesthesia, Harvard Medical School, Beth Israel Deaconess Medical Center Department of Anesthesia Critical Care and Pain Medicine, Boston, MA. He is Co-Founder of The Institute for Safety in Office-Based Surgery (ISOBS), Immediate Past President of the Massachusetts Society of Anesthesiologists and member of ASA Committees on Patient Safety and Education, Quality Management and Departmental Administration (QMDA), Governmental Affairs, and Ambulatory Surgical Services. He can be reached at fshapiro@bidmc.harvard.edu.
Recent Posts
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The Institute For Safety in Office-Based Surgery (ISOBS)
In recent years, the economic pressures of medicine have incited a paradigm shift in health care delivery, such that surgical procedures are moving from the hospital to the office-based setting. Often called the “wild west of health care,” office- based procedures continue to increase at a rapid pace, with an estimated more than 10 million procedur ...Feb 01 -
Other entries by Fred E. Shapiro, D.O.
Bryan T. Sullivan
Bryan T. Sullivan, PMP, serves as the Director of EMR and Clinical integration for ABC. Mr. Sullivan came to ABC from Merge Healthcare where he managed and delivered Anesthesia EMRsolutionstothehealthcaremarket. He focuses on providing anesthesia and pain providers with clinical and operational systems as well as integrating existing EHRs. He can be reached at Bryan.Sullivan@AnesthesiaLLC.com
Recent Posts
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How Does Cloud Computing Fit into Anesthesia?
“Cloud Computing” is a phrase we hear thrown about constantly in the technology industry these days. To the casual observer, it can be synonymous with the internet or perhaps used to identify a specific program available over the web. Large organizations such as hospitals typically understand the nuance that exists when discussing and integrating c ...Feb 01 -
Other entries by Bryan T. Sullivan
Neda Ryan, Esq.
Neda Ryan, Esq. is an associate with Clark Hill, PLC in the firm’s Birmingham, MI office. Mrs. Ryan practices in all areas of health care law, assisting clients with transactional and corporate matters; representing providers and suppliers in health care litigation matters; providing counsel regarding compliance and reimbursement matters; and representing providers and suppliers in third party payor audit appeals. She can be reached at (248) 988-5884 or at nryan@clarkhill.com.
Recent Posts
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HIPAA Omnibus Rule: What Anesthesiologists Must Do Now
On January 25, 2013, the US Department of Health and Human Services (HHS) Office of Civil Rights (OCR) issued its long-awaited Health Insurance Portability and Accountability Act of 1996 (HIPAA) final omnibus regulations (Final Rule). The Final Rule modified the HIPAA Privacy, Security, Enforcement and Breach Notification Rules (HIPAA Rules) and is ...May 08 -
A Survey of State Prompt Pay Laws, Part II
Part I of this survey (Alabama-Missouri) appeared in the Fall 2012 issue of the Communiqué. In Part II, we summarize the laws and regulations that require health plans to pay claims within a given period in the remaining states (Montana-Wyoming), as well as the penalties for violations. ... ...Feb 21 -
A Survey of State Prompt Pay Laws, Part I
Many states have laws or regulations in place that require health insurers in the state to reimburse claims within a certain timeframe or face penalties, oftentimes in the form of interest applied to the amount of the claim. Such laws or regulations are typically called “Prompt Pay” laws or “Clean Claim.” While each state or, sometimes, insurer, de ...Oct 26 -
Anesthesiologists Should Beware of HIPAA Audits
The acronym “HIPAA” has become a household name since the enactment of the Health Information Portability and Accountability Act of 1996, which, among other things, established rules for protecting and securing patients’ health information. In fact, it is not uncommon to hear about breaches of patient information costing healthcare providers and su ...Oct 03 -
Anesthesiologists Should Beware of HIPAA Audits
The acronym “HIPAA” has become a household name since the enactment of the Health Information Portability and Accountability Act of 1996, which, among other things, established rules for protecting and securing patients’ health information. In fact, it is not uncommon to hear about breaches of patient information costing healthcare providers and su ...Apr 25 -
Other entries by Neda Ryan, Esq.
Mark F Weiss, Esq
Guest has not set their biography yet
Recent Posts
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Are You Making This Mistake Concerning Competition?
“The Competition” These days I hear that term from more and more anesthesia group leaders, and I’m sure that you’re thinking about it more than you’d like. From the Latin root competitionem, its meaning originated in the sense of rivalry, of a contest for something. Since at least the 1790s, it’s been used to describe rivalry in the ...May 22 -
Update on the Company Model and Other Schemes—OIG Issues Advisory Opinion
In a much awaited pronouncement, on June 1, 2012, the U.S. Department of Health and Human Service’s Office of Inspector General issued Advisory Opinion 12-06 addressing the propriety of two popular schemes to extract money from anesthesiologists, the so-called “company model” and the purported “management fee.” The advisory opinion c ...Dec 20 -
Update on the Company Model and Other Schemes—OIG Issues Advisory Opinion
[Author’s Note: A version of this article originally appeared in the August 2012 issue of Anesthesiology News.] In a much awaited pronouncement, on June 1, 2012, the U.S. Department of Health and Human Service’s Office of Inspector General issued Advisory Opinion 12-06 addressing the propriety of two popular schemes to extract money from a ...Nov 07 -
Medical Directorship Of Anesthesia Services: Are You A Player...Or Are You Just Being Played?
Wow, what a day! You've just left a meeting with the hospital's CEO. Of the fifteen anesthesiologists in your openstaffed department, the CEO wants you to be the new, first medical director of anesthesia services. You've been the department's chair for the past two years, but now you've been offered an administrative stipend of $2,500 a month. It d ...May 25 -
Managing For Success Requires Managing Risk
Opportunity and risk. Risk and opportunity. Janus-like sides of the same coin. Of course, the greater the opportunity, the greater the risk. In a medical practice sense, anesthesiologists are surrounded by risk and are supremely aware of its existence. On a daily basis, you administer drugs that under other circumstances would be deadly. You’r ...Mar 28 -
Other entries by Mark F Weiss, Esq
Jody Locke, CPC
Vice President of Anesthesia and Pain Management Services, ABC
Recent Posts
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Is Big Better?
I am an anesthesiologist. The leadership of my small group of 15 physicians has been negotiating a merger with the large group in a nearby city. They have made some compelling arguments for the strategic advantages of an affiliation with a larger entity. But as logical as the rationale for merging is, so are the concerns and the questio ...Feb 28 -
Anesthesia Quality Databases
The focus on quality outcomes in healthcare has been long in coming. As the cost of health care continues to rise faster than the cost of living, the nation finds itself facing a dilemma. Perhaps a free market approach to healthcare is not the best approach after all. Economic incentives and ground breaking research have clearly provided ...Oct 10 -
What is Your Value Proposition? Is Your Practice the Steak or the Sizzle?
Anesthesia is the quintessential service specialty. Establishing and maintaining a consistently strong relationship with a hospital, a clinic or an ASC is no easier for an anesthesia group practice than for any other type of service provider, be it car mechanic, internet provider or hair stylist; today’s medical consumers know they have optio ...Feb 15 -
Getting Paid for Anesthesia: Mastering the Challenges of Viability
Some of us are old enough to remember the days when anesthesia prtoviders got paid more or less based on what they decided to charge. It used to be that a favorable mix of patient insurance coverage (payor mix) and reasonably busy operating rooms was sufficient to ensure the financial viability of an anesthesia practice. There was a time when anest ...Feb 01 -
Other entries by Jody Locke, CPC
Franc Galinanes
Senior Director, North American Partners in Anesthesia, Melville, NY
Member at Large, MGMA Anesthesia Administration Assembly (AAA) Executive Committee
Member at Large, MGMA Anesthesia Administration Assembly (AAA) Executive Committee
Recent Posts
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Knowledge is Power: Why Anesthesiologists Need to Capture, Analyze and Use Data
While the eventual fate of the Patient Protection Affordable Care Act (PPACA) will be decided in the near future, by either the Supreme Court or the next Congress and Administration, what is not open for debate is that healthcare has changed. As the business of medicine evolves to accommodate the changes called for in the healthcare reform laws, so ...Oct 08 -
Anesthesia: The Increasing Consolidation of our Industry
While the business of health care continues to evolve, there is perhaps no part of it changing faster than anesthesia. Numerous factors are quickly shifting the market towards an even more competitive and demanding landscape. The days of anesthesia groups simply providing clinical coverage in a hospital’s operating rooms are, for better or for wors ...Feb 01 -
Other entries by Franc Galinanes
Sara Carpenter, CPA
Sara Carpenter, CPA has not set their biography yet
Recent Posts
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Federal Insurance Legislation - Can It Help Me?
WHY FEDERAL INSURANCE REGULATION?Normally, insurance companies are regulated by the states. As a result there are hundreds of statutes and rules affecting companies that operate in multiple states. The National Association of Insurance ComNAIC, missioners (NAIC) issues guidance to standardize insurance laws, but states are not required to follow it ...Feb 08 -
Other entries by Sara Carpenter, CPA
Arne Pedersen
Arne Pedersen, MBA, FACMPE, serves as Director of Client Services for ABC. He is a Fellow of the American College of Medical Practice Executives. His distinguished background includes serving as a former Anesthesia Group Administrator, an expert on leadership, and a Bronze Star Medal recipient from the Persian Gulf War. Mr. Pedersen authored the book, “Lead with Intent” a comprehensive, yet practical leadership bible with a vision of training leaders. Mr. Pedersen serves an adjunct professor at the University of Notre Dame in the Executive Education Certificate Program and teaching Performance Management.
Recent Posts
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Approaches to Collecting from Self Pay and High Deductible Patients
With the ever-rising cost of healthcare, all parties are looking for ways to finance it. From high deductible health plans with savings components to consumer credit tools such as credit cards and loans, the face of healthcare financing is changing. The challenge for anesthesia in this ever-changing world comes back to the physician-patient relatio ...Oct 24 -
Planning for Payor Negotiations
Every year, the time comes to begin looking at one or a set of payor contracts. A multitude of questions abound regarding appropriate rates, term length, and whether or not to participate or stay on panel. These are all good questions to raise. But are these the only questions to ask? This article seeks to explore the value of planning for payor ne ...Oct 03 -
Planning for Payor Negotiations
Every year, the time comes to begin looking at one or a set of payor contracts. A multitude of questions abound regarding appropriate rates, term length, and whether or not to participate or stay on panel. These are all good questions to raise. But are these the only questions to ask? This article seeks to explore the value of planning for payor ne ...Apr 27 -
The Benefits of Strategy
There are many forces affecting anesthesia groups today such as the pending Supreme Court ruling on the Patient Protection and Affordable Care Act, high unemployment, pending cuts in Medicare, and a very slow economy. Regardless of what one believes, strategically addressing these issues is paramount in providing the necessary road map for th ...Feb 22 -
Other entries by Arne Pedersen
Moe Madore
Moe Madore has not set their biography yet
Recent Posts
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Where Do We Fit In The Alphabet Soup?
For the last several months the literature on Accountable Care Organizations (ACOs) has flourished. So has the volume of workshops, seminars and webinars, all with the intent of educating providers on what the future will look like, and many addressing how physicians might participate. Independent anesthesia groups are trying to not only understand ...Mar 07 -
Other entries by Moe Madore
Karin Bierstein, JD, MPH
Vice President for Strategic Planning and Practice Affairs, ABC
Recent Posts
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The PROMETHEUS Payment® Model Dividing The Pie for an Episode of Care
When physicians, hospitals, home health agencies and other providers decide to create an Accountable Care Organization or other integrated delivery system, one major issue that will soon command attention is the distribution of patient care revenues. How will the various providers share the pie?One model comes from the PROMETHEUS® Payment allocatio ...Mar 09 -
Other entries by Karin Bierstein, JD, MPH
Stephanie J. Zvolenski, MBA
Guest has not set their biography yet
Recent Posts
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Should I Change Banks? Understanding Bank Ratings
With headlines of economic downturn, health care reform, and decreased reimbursements, many physicians are asking the questions, “Is My Money Safe?” “Should I Change Banks?”The first step to take in answering these questions would be to determine your bank’s rating. To help educate the average depositor, we researched the methodology behind bank ra ...Mar 22 -
Other entries by Stephanie J. Zvolenski, MBA
John T. Mulligan
John T. Mulligan is a Member of the law firm McDonald Hopkins, LLC, in is Cleveland, Ohio office. McDonald Hopkins has other offices in Chicago, Detroit, Columbus, West Palm Beach, and Dennis Mass. John’s practice focuses on the representation of physicians and physician groups, with a particular focus on the representation of hospital-based groups. He is listed in the “Best Lawyers in America” for health care law. He can be reached at (216) 348-5435 or jmulligan@mcdonaldhopkins.com.
Recent Posts
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Re-Assessing Anesthesia Group Administration
From time to time anesthesia groups find that they need to reassess their administration or decision-making processes. This can involve everything from tinkering with how routine day-to-day administrative activities are carried out, to totally revamping the group’s governance structure.Reassessments can come about for a variety of reasons. There ma ...Mar 30 -
Other entries by John T. Mulligan
Hal Nelson
ABC Director of Compliance and Client Services
Recent Posts
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The Billing Nuances of Post-Op Pain
The variety of commonly used modalities for the management of post-operative surgical pain makes it imperative that practitioners understand the specific documentation and billing requirements of each option. Listed below are the five most common approaches and their corresponding claims submission guidelines. As is always the case, reimbursement ...Apr 05 -
Other entries by Hal Nelson
Joe Laden
Joe Laden has served as the Business Manager for Anesthesia Associates of Louisville, PSC since 1981. He has written many articles about anesthesia business topics and has made presentations at MGMA, ASA and other business conferences. To contact Joe with any questions or comments about information in article: joeladen@aalouisville.com. More lists of academic and private practice websites can be found at http://sites.google.com/site/joeladen/Home
Recent Posts
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Anesthesiology Practice Web Sites
Virtually all large anesthesiology practices have a corporate website. Some are quite detailed and complex. Fewer medium and small practices maintain a web presence. Should every practice consider creating a practice website or upgrading its current site?After examining a number of anesthesia practice websites, one can see that most have common ele ...Apr 12 -
Other entries by Joe Laden
Franc Galinanes
Franc Galinanes is a Senior Director at North American Partners in Anesthesia, a national Anesthesia Management Company and also serves as a Member at Large on the MGMA Anesthesia Administration Assembly (AAA) Executive Committee. He can be reached at fgalinanes@NAPAanesthesia.com.
Recent Posts
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Knowledge is Power: Why Anesthesiologists Need to Capture, Analyze and Use Data
While the eventual fate of the Patient Protection Affordable Care Act (PPACA) will be decided in the near future, by either the Supreme Court or the next Congress and Administration, what is not open for debate is that healthcare has changed. As the business of medicine evolves to accommodate the changes called for in the healthcare reform laws, so ...Apr 18 -
Other entries by Franc Galinanes
Joette Derricks, CPC, CHC, CMPE, CSSGB
Joette Derricks, CPC, CHC, CMPE, CSSGB serves as Vice President of Regulatory Affairs and Research for ABC. She has 30+ years of healthcare financial management and business experience. Knowledgeable in third-party reimbursement, coding and compliance issues, Ms. Derricks works to ensure client operations are both productive and profitable. She is a long-standing member of MGMA, HCCA, AAPC and other associations. She is also a sought-after nationally-acclaimed speaker, having presented at AHIMA, Ingenix, MGMA and HCCA national conferences. You can reach her at Joette.Derricks@AnesthesiaLLC.com.
Recent Posts
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Health Information Management Challenges in the World of EHR
There is no doubt that the emergence of the Electronic Health Record (EHR) program is changing the way providers capture documentation on the front end. According to the 2012 NCHS Data Brief, 55 percent of physician groups have already adopted an EHR. Among the 45 percent that have yet to implement an EHR system, nearly half plan to purchase or ...Apr 11 -
Three Common Issues
The Centers for Medicare and Medicaid Services (CMS) Contractor Medical Directors (CMDs) recently put together a list of common CMS claim issues that were of concern to various contractors. Several of these items involve services that may impact anesthesia or pain management providers. 1. Use of modifier -59 for imaging with those pr ...Jan 24 -
Clarifying TEE ’s Coding and Documentation Requirements (CPT 93312-93318)
Several clients have inquired as to the documentation and correct coding and billing for Transesophageal Echocardiography (TEE) services. A TEE is a special diagnostic tool, which may be used by properly trained physicians (i.e., anesthesiologists, cardiologists) to benefit patient care. A separately reported TEE may be performed for mo ...Oct 17 -
Other entries by Joette Derricks, CPC, CHC, CMPE, CSSGB
Christine Sikora, CHM
Christine Sikora, CHM is the Practice Administrator with Hartford Anesthesiology Associates, Inc., (HAA), in Hartford, CT, since 1998. Working with this 85 member physician anesthesia practice, Ms. Sikora focuses on corporate as well as daily operational responsibilities that include regulatory compliance and auditing, QAPI Program and staff privileging and credentialing. Contact her at (860)-545-2033 or csikora@harthosp.org.
Recent Posts
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More Ingredients for your Alphabet Soup
All of you are familiar with some of the regulatory requirements that affect your practice, as identified by their acronyms and initials: HIPAA, CMS, CoPs,PQRS, SCIP, ACO, HCAHPS. For hospital-based practices, there are now two additional “ingredients” in our regulatory alphabet soup that will require your attention: OPPE and FPPE. ...Mar 29 -
Other entries by Christine Sikora, CHM
