Summary: As the specialty of anesthesia evolves, new lines of business are explored and employed. Over time, however, what once seemed like a cutting-edge technique or profitable opportunity may ultimately come with certain risks. Acute pain management is a prime example of this reality.There was a time, not too long ago, when many anesthesia pract...

Summary: The rules surrounding the use of an advance beneficiary notice are voluminous and complex. Because of this, many providers are hesitant to avail themselves of this billing solution. In this ongoing series of articles on ABNs, we will cover additional rules for the proper use of an ABN when the provider believes the service that the pa...

Summary: It is not enough in this day and age for anesthesia groups to rely on a few staff and on the same processes. If they want to maximize reimbursement while staying compliant with ever-changing rules, anesthesia providers need to consider the value that a sophisticated billing operation can bring to their practice.There is a natural human ten...

Summary: The particulars of when and how to use an advance beneficiary notice can be complex. Sometimes the notice is required, but occasionally its usage is voluntary. Today's article addresses some of the key regulations governing the issuance of an ABN when Medicare is expected to deny payment.Nothing is more frustrating for the entrepreneur tha...

Summary: The billing rules applicable to the practice of anesthesia are particularly complex when compared to other specialties. Anesthesia providers need to understand the nuances of these rules as they pertain to anesthesia services, OB services and flat-fee procedures. Today's article tackles all three.The most common question our clients u...

Summary: Some anesthesia groups have flirted with various business models that may or may not be in compliance with federal or state laws. Today's article takes a deep dive into the company model. We will review the OIG's rulings on this model and make recommendations on what anesthesia practices should consider before moving forward with such vent...

Summary: Anesthesia groups that once experienced stability are now facing stresses due to various factors. It is becoming increasingly critical for groups to use data-driven metrics to secure reasonable agreements with their hospital administrations. The standard model of such agreements may also be changing.Every anesthesia practice must define i...

Summary: The No Surprises Act saga continues to slowly unfold as regulations, court opinions and notifications drip out on an intermittent basis. Today's alert provides an update on the situation and what the anesthesia community may expect in the future.The No Surprises Act (NSA) was designed to remove the unexpected costs of out-of-network (OON) ...

​Summary: ​The No Surprises Act saga continues to slowly unfold as regulations, court opinions and notifications drip out on an intermittent basis. Today's alert provides an update on the situation and what the anesthesia community may expect in the future.​​The No Surprises Act (NSA) was designed to remove the unexpected costs of out-of-netwo...

We know what we believe. On those topics about which we are particularly passionate, we are usually able to marshal the facts in support of our stance. Our experience and knowledge base—when coupled with that personal sense of rightness—allow us to be confident in successfully articulating our position. The problem with all this is that the person ...

Summary:  It is becoming more and more evident that, as cases move from the hospital to the surgery center, anesthesia staffing of the hospital becomes increasingly inefficient from a logistical and financial perspective.One of the most significant challenges to hospital-based anesthesia practices is the need to make providers available to co...

SummaryThere are a few changes in store for chronic pain providers in 2023 based on the most recent government proposals. Today's alert summarizes some of the key pain-specific provisions coming from CMS.We recently provided an alert on the 2023 Medicare Physician Fee Schedule (PFS) Proposed Rule (PR). In that alert, we focused primarily on those p...

Summary:  For certain surgeries, staffing one anesthesiologist for three or four overlapping cases can increase complications in patients post surgery.Most major surgeries would not be possible without the skilled services of an anesthesia provider to render the patient unconscious and pain free. It is the anesthesia provider who ultimately e...

Summary:  The government releases its proposed Medicare fee schedule for 2023. It's a mixed bag for anesthesia providers.It's one thing to propose; it's another to follow through. When a plan is accepted and put into action, the planners can look back with pride on the day their proposals were first put down on the drawing board. Proposals ar...

Summary:  Not every anesthesia practice has a winning strategy when it comes to the all-important relationship with the hospital. Today's article addresses the dynamics of that relationship and how anesthesia groups can successfully manage it.Too many anesthesia practices are experiencing a less than collaborative relationship with the admini...

Summary:  Assigning and supporting the patient's ASA status should not be approached in a haphazard or ho-hum manner, as its implications are far-reaching.​The world of tomorrow, as envisioned by futurists, such as Ray Kurzweil, Elon Musk and others, may very well witness an evolutionary shift where artificial intelligence and advanced roboti...

While there has been some concern about a loss of revenue due to the implementation of the No Surprises Act and its corresponding regulations, our own review indicates that, in most cases, there has been no negative financial impact on anesthesia groups. Although the No Surprise Billing Act was intended to protect patients from excessive surprise ...

There is always, it seems, an exception to every rule—an "exception that proves the rule." It's always "i" before "e," except after "c," right? You can turn right on red, except in those jurisdictions that don't allow it. Exceptions to rules are pervasive throughout our daily life, and they exist in the anesthesia world, as well.The General RuleA l...

With changes in hospital profit margins, it is time for anesthesia practices to take greater hold of their own financial reins. This will necessarily involve a different approach to their relationships with the administration.Routine can be a good thing. It keeps us on track and hopefully continuing on a positive path. Every morning, you make up th...

Data is key to a successful anesthesia practice; but what good is data if it is not being reviewed, properly understood and effectively utilized? Today's article addresses the history and future of anesthesia metrics.Conventional wisdom holds that anesthesia practices are captive to the facilities they serve. It is the location of the facility that...