Summary: The new year brings with it a new federal rule that restricts balance billing in out-of-network cases. There will also be a new process in place for self-pay or uninsured patients. Today's alert acts to remind readers of what they can expect and what they must do when faced with either of these scenarios. Starting with the first day o...

​SUMMARY: While the anesthesia specialty is seeing a general downward trend in reimbursement due, in part, to an increase in Medicare payer mix and a growing stinginess on the part of third-party payers, orthopedics continues to be a relatively profitable line of business. Over the past months, we have tended to focus on policy updates an...

In this final installment of our review of the 2022 Medicare Physician Fee Schedule, we address some of the remaining topics that may be of interest to either anesthesia or chronic pain providers. This includes some possible good news on the reimbursement front. In our first two alerts dealing with last month's release of the 2022 Medicare Physici...

​Today's anesthesia practices must understand the current shift in patient demographics and determine how that will impact their practice parameters and revenue. Groups must have plans in place to deal with the changing realities.Anesthesia has been undergoing a significant paradigm shift. It used to be that the primary focus and concern of anesthe...

A few months ago, we published an alert describing new hurdles Medicare put in place for anesthesia providers in connection with facet intervention cases. Now, Medicare is making it more difficult to get paid in epidural steroid injection (ESI) cases. Beginning this month, a new policy will go into effect across the country that will dramatically r...

Summary: Today's alert continues our summary of the changes in store next year for Medicare providers. Highlights include chronic pain coding changes, modifications to the teaching rules and quality standards.Provider Relief Fund Reporting Deadline: November 30, 2021A reminder that if you received Provider Relief Fund (PRF) payments totaling m...

​Summary: When it comes to assessing the appropriate size of your anesthesia practice, several factors must be considered. Understanding the practice's constituent parts and other variables will aid in determining what size works best. As Americans, we have a fascination with bigness. We are raised in the belief that bigger is better, especial...

Summary: It should come as no surprise to our readers that reimbursement for Medicare services has been going in the wrong direction. That trend will not be reversed in 2022. This and other items arising from the 2022 Medicare Physician Fee Schedule Final Rule are discussed in today's alert. On November 2, 2021, the Centers for Medicare &...

Summary: Determining the next leader for your group may be a critical endeavor. Are you certain the approach is the right one? Have you considered the bases for the decision? What leadership model is optimal for your group and for its ultimate success? These issues are addressed in today's alert. A critical aspect of any governance model ...

SUMMARY: How do anesthesia providers account for time spent in cases that contain a delay on either the front end or back end? Today's alert provides recommended solutions for such scenarios.It happens occasionally. A teacher waits for a delayed parent to pick up the last remaining child at the end of a school day. The babysitter demands another te...

SUMMARY: Negotiating an anesthesia services agreement involves a nuanced approach and an appreciation of the role that all the important parties play. To be successful in such a negotiation, anesthesia groups should consider the recommendations discussed in today's alert.It used to be that when an anesthesia services agreement came due, the he...

Summary: When the anesthesia provider opts for monitored anesthesia care in a patient case, what is he/she really signing on to? This anesthesia technique is a bit slippery in terms of identification, requirements and even payment. Several months ago, we published an article on the three anesthesia techniques available to anesthesiologists and...

Summary: So many anesthesia groups are so busy meeting the service requirements of the facilities they serve that they often fail to take a step back to consider just why they feel so overwhelmed and what they can do about it. Strategic planning can prove to be an invaluable business tool. There is a tendency to think of strategic planning in ...

SUMMARY: The federal government has just released new regulations that provide details for implementing provisions of the No Surprise Act. How will this affect anesthesia providers? Today's alert takes a look.On September 30, 2021, the U.S. Department of Health and Human Services (HHS), along with other federal departments and agencies, issued an i...

We all know that anesthesia is an essential element in the running of an operating room. It is the anesthesia provider who makes it possible for the surgeon to successfully perform the procedure. Patients must remain motionless, be pain free and not have any unexpected reactions to the trauma of the surgery. Many would even say that anesthesia prov...

Summary: Not every anesthesia case ends as planned. Some never get off the ground. In such circumstances, are there still opportunities for reimbursement? Today's article explores those possibilities.All good things must come to an end, or so the saying goes. The problem arises when they come to an end too soon—suddenly and unexpectedly. Often...

​ Summary:  Managing expectations in the business environment can be a bit tricky. Anesthesia groups have certain expectations that have always been placed upon them. The problem comes when these expectations are increased in number and intensified in detail. Today's alert reviews the continual mission creep being experienced by many of our an...

It's all in how you finish. Sprinting out of the gates at the sound of the starting gun during a local marathon will put you in the lead for a while. You'll look pretty good in comparison to all your competitors, at least for a short time; but, because you expended so much energy at the outset, you're likely to quickly tire and wind up finishing de...

Summary: Anesthesia retains a unique tool that has the potential to positively reshape efficiency, financial viability and work flow. The problem is that this tool is so often poorly wielded by both the group and the facility. Historically, revenue cycle management companies have developed their software to navigate the intricacies and exigen...

Summary:  For doctors who medically direct, their primary focus should be the room or rooms they are overseeing. Nevertheless, national and local Medicare rules allow the medically directing doctor to perform certain other services, as well. What are these services and are they applicable in every jurisdiction? Today's alert provides answers....