Medical Business Management would like to join with the American Association of Nurse Anesthetists (AANA) in honoring Certified Registered Nurse Anesthetists during National CRNA week. The week of January 20th has been set aside to show appreciation for CRNAs and to raise awareness for the important work that they do.
Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years.
A CRNA doesn’t see their work day as full of procedures to be completed, but full of individuals to be cared for. They are the calming voice that put your fears at ease as they prepare you to undergo your procedure and reassure you that you’re in good hands. These nurse anesthetists are your advocate. They stay with you from start to finish and provide a full spectrum of care while they speak on your behalf to the entire medical team and make sure you stay comfortable throughout your procedure. Known for their personal touch, they are the heart in what can otherwise feel cold and routine. While the doctors and nurses are focused on specific tasks, the CRNA keeps a big picture perspective to ensure your overall well-being. This perspective can play a vital role in coordinating patient care and ensuring the best possible outcome. Join us in saying “Thank you!” to all our CRNAs.
CRNAs are constantly facing new challenges. Medical Business Management values our relationship with CRNAs nationwide, and we are committed to helping our clients navigate these uncertain times. Even if policies change, the expertise that we bring to practice management, coding, reimbursement, and billing will ensure that you are compensated fairly and in a timely manner.
Do you have questions about the work that we do for CRNAs? Contact us today for more information.
Traditionally, MAC anesthesia cases and general anesthesia cases were very easy to differentiate. General anesthesia refers to patients that are completely asleep and have an endotracheal tube down the throat. MAC anesthesia (Monitored Anesthesia Care) refers to patients that are not completely asleep (various levels of sedation) and were not intubated.
Propofol has completely changed the nomenclature.
Anesthesia is a continuum, not a designated “label” or “level”. Anxiolysis, light sedation, moderate sedation, deep sedation, general anesthesia.
General anesthesia by definition is when a patient loses their protective airway reflexes. When they are so sedated that they can no longer swallow saliva, gag reflex has been obtunded, may quit spontaneously breathing, and may obstruct easily.
MAC anesthesia by definition is when the patient receives varying levels of sedation to achieve ideal procedural conditions with patient interaction.
An anesthesia provider can give a little propofol and the patient will be amnestic, yet still have eyes open (awake). This by definition would be a MAC or light sedation. However, the anesthesia provider can give a larger dose of propofol and put patient completely asleep so a gastroenterologist can pass a scope into their stomach without the patient gagging or fighting, this by definition would be a general.
From our experience, most if not all endoscopy cases are really general anesthetics by definition.
According to the ASA relative value guide, the type of insurance should not impact reimbursements, however, many payors now have Monitored Anesthesia Care requirements. Understanding the difference between MAC and General allows the billing company to apply the correct anesthesia modifier and for the claims to be paid quickly and correctly.
Monitored Anesthesia Care (MAC) includes all aspects of anesthesia care, a pre-procedure visit, intra-procedure care and post-procedure anesthesia management. While MAC may include the administration of sedatives and analgesics often used for Moderate Sedation, the MAC provider must be prepared and qualified to convert to general anesthesia when necessary.
MAC allows for the safe administration of maximal depth of sedation. MAC provides the ability to adjust sedation levels from full consciousness to general anesthesia during the course of a procedure; this flexibility provides matching sedation levels for the patient and proceduralist requirements to achieve ideal procedural conditions.
During a MAC procedure, if the patient loses consciousness and the ability to respond purposefully, the anesthesia care by definition is converted to a general anesthetic regardless of whether airway instrumentation is required.
MAC anesthesia requires post-procedure care such as return to full consciousness, relief of pain, psychological support and physical comfort as well as the diagnosis and treatment of co-existing medical problems.
Monitored Anesthesia Care is a physician service that must be provided by a qualified anesthesia provider, it should be subject to the same level of payment as general anesthesia.
Anesthesia Salaries Are Increasing – But for How Long?
Even in an overall flat-pay situation for medical professionals, anesthesia salaries are on the rise—but there’s a threat to that trend in the form of a decrease in the number of surgeons. This could cause a future drop in the demand for anesthesiologists, leaving some anesthesia providers out of work.
The Bureau of Labor Statistics states that physician pay is stable, but from 2004 to 2014, salaries for anesthesiologists has increased. A study led by David DeKorte, JD, from Pennsylvania State University, collected data from the Bureau of Labor Statistics, the U.S. Department of Education, and the Association of American Medical Colleges to determine the effect of educational interest and salaries on the future of anesthesiology. His findings were presented at the 2017 PostGraduate Assembly in Anesthesiology.
From 2004 to 2014, the increase in anesthesia salaries was a rate of 1.21% per year—higher than any other sector in the medical field. The salaries for anesthesiologists in 2014 was higher than other specialties, boasting a median of $246,650—a significant $6,000 more than surgeons, who came in as the second highest-paid group. The field of anesthesiology grew almost 20% during this time period, as well, while the other fields only saw growth of 3%.
Unfortunately, while anesthesiologists were experiencing a raise in pay, surgeons were seeing a decline of professionals in their field. In the same time period (2004-2014), the number of surgeons fell 26.4%—over 4% per year. According to Mr. DeKorte, the reasons for this decline were myriad, from the demands of residency to the burden of student debt. Additionally, surgeon salaries have increased only 0.55% per year, which may also contribute to the decreased numbers of people entering that occupation.
Educational expenses play into this equation as well, with undergraduate and medical training costs having risen 23% and 27.9% respectively. It’s true that admissions to medical school have gone up, but the significant growth in student debt may cause students to avoid specialties that require long, costly residencies.
The decline in surgeons could result in a lower demand for anesthesiologists, which could have a long-term effect on both anesthesia salaries and the number of anesthesiology positions available. And that’s assuming students continue to believe that the cost of medical school and all its trappings is worth it—which, given that they’ll be paying about half of their income to student loan debt upon finishing, isn’t necessarily a given.
Here at Medical Business Management, we believe that physicians should be able to focus on their practice and their patients. To help them accomplish that, we are available to take on their billing and coding, collecting payments and following up with unpaid bills as necessary.
If you’d like to find out more about what we can do for your practice, contact us today.
You may not think about anesthesiologists needing or using smartphone apps for their practice, but there are several out there that are worth checking out. Always do your homework, of course, and make sure that these apps fit your needs and work accurately before using them; we make no claims that these apps are flawless or are a good fit for your practice.
That said, they could be helpful to you or your staff. Read on!
With MACRA’s implementation in 2017, anything that makes the process easier is worth its weight in gold. This app allows you to capture necessary measures and report your MACRA requirements. By tracking far more than just quality, you’ll have an unprecedented view into operational excellence. Learn more at macraready.com.
This app could be a great tool for anesthesiologists, CRNAs, veterinarians, and anyone else involved with anesthesia. Whether you’re a resident or you’ve got 25 years of experience under your belt, you can benefit from this app’s real-time case capture, modeled interactions, and more.
Released in 2009 and updated in November 2014, this app is available in the app store for $19.99 and can be used on an iPhone, iPod Touch, or iPad.
Whether you need a quick refresher or you’re looking for a deeper understanding of a concept, this app has the tutorials you’re looking for. Great for students, too. It’s available in the app store for $59.99 and can be used on the iPhone, iPod Touch, and iPad.
With five comprehensive resources included, Anesthesia Central offers a free preview so you can try before you buy. Find it in the app store for free, then purchase for $99.99 after one year to continue receiving updates.
Our goal is to help anesthesiologists focus on their patients – not on paperwork, coding, or claims. The above apps could help to streamline your practice, and so could letting us handle all your billing and coding. Contact us today for more information on how we can remove these burdens and help your practice thrive!
Every year, the United in Patient Safety campaign comes to a close with Patient Safety Awareness Week. This year, March 12-18 is the observed week for dedicating time and energy to increasing awareness for patient safety. In order to further this cause, the National Patient Safety Foundation brings health professionals and patients together to spread the message about the importance of patient safety.
Read on for ways to get involved!
If your practice has a Facebook page, a Twitter account, an Instagram account, or a Snapchat account, be sure to post pictures of your staff in their patient gowns and explain that you are observing Patient Safety Awareness Week! Not sure what to say in your post? Try these helpful pre-written samples.
There are lots of materials for the campaign available for download online. You can also order items specifically for Patient Safety Awareness Week.
To make sure your practice stays in the loop for all campaign activities, take a moment to register here.
One interactive way to engage the purpose of this week is by discussing patient safety issues with other health care professionals. Through this discussion forum, you can take part in conversation surrounding health care issues, share your own experiences, and learn from the expertise of others. Join the discussion here.
Make Patient Safety Awareness Week a Success!
At Medical Business Management, we’re passionate about the wellbeing of patients and health care professionals alike. That’s why we offer services meant to relieve stress and encourage more efficient productivity. Ready to talk to us about how we can help your practice reach its full potential? Contact us today!
CRNAs (Certified Registered Nurse Anesthetists) are a foundational element to the entire anesthesiology industry. But many people don’t know what the everyday life of a CRNA is like. Today, we’d like to take you behind the scenes and show you what these amazing professionals do every day – and how they strive to serve their patients to the best of their ability.
For CRNAs, the number one priority every day is to give patients safe access to anesthesia care. As you can imagine, this comes with a great amount of responsibility and accountability. Many patients are nervous about their upcoming procedure, and it is the CRNA who connects with these patients upon arrival and sets the tone for the entire experience. Seemingly small things, like offering a warm blanket to the patient, can go a long way in helping them feel calm.
Additionally, a CRNA makes sure that the patient is informed about the details of the procedure before it happens. They answer questions and reassure the patient that they will be present from start to finish. The CRNA monitors vital signs during the procedure, and makes adjustments to anesthesia accordingly.
What Are the Biggest Challenges for CRNAs?
Many of a CRNA’s struggles can be traced back to the health care industry itself. With ever-changing policies, patient care is often determined by a governing body who has no connection to the patient as opposed to the health care provider who is personally assessing the patient. Because of this, many CRNAs are not able to do what they truly believe should be done, and must instead stick to a one-size-fits-all policy.
What Are the Biggest Rewards for CRNAs?
The greatest rewards for a CRNA are usually intangible. Connecting with a Veteran and hearing stories from their time in service can be quite emotional, as well as being in the room when a baby is born.
The truth is that CRNAs are incredible people. They love to connect with patients, they take their jobs very seriously, and they strive to provide the very best health care possible. If you know a CRNA, thank them today – and if you are a CRNA, thank you!
Looking for a billings solution for your anesthesiology practice or independent CRNA group? Look no further than the solutions we offer. Contact us today for more information!
The past decade has brought about a great expansion of the market share of anesthesia services by anesthesia management companies (AMCs). But what does this mean, and what are the pros and cons? Read on to find out with Medical Business Management.
What Do Anesthesia Management Companies Do?
AMCs take advantage of their large networks to get higher rates from commercial insurance providers. Then, they utilize their control over the market to lower employee compensation costs. They are buying private practices across the United States at a rapid pace, and they are owned by investors who are motivated by profit.
What Do Proponents of AMCs Say?
Those who support AMCs suggest that there is a decrease of costs of benefits based on the economy of scale. They also say that the negotiation of higher commercial insurance rates causes a decrease in the cost of subsidies paid for by hospitals.
Are these suggestions wrong? No, but the same results can be achieved via other methods. For example, superior employment cost savings can be realized by following CRNA-only and collaborative models, and eliminating providers with high costs and low revenue.
What Do Opponents of AMCs Say?
On the other hand, those who oppose AMCs providers will work harder for less money if a third-party entity (which demands revenue and increased profitability each quarter) is added. Another consideration is that AMCs often have their own way of doing things, which doesn’t always take into account a facility’s unique needs.
But possibly the greatest negative here is that there is no incentive to go above and beyond the standard requirements. If a provider is paid a flat hourly rate or a salary, with no incentives or ownership, then they will likely stop working when their shift is over. That means no staying late for extra cases, which is normal in a fee-for-service setup because each case adds more income. It also means no concern for turnover, because more cases just mean more work, but no more money.
In fact, the incentive is to work less… not more. Pay is the same, so why work harder when there’s no payoff to doing so?
Whether you need help with pain management billing or claim coding, MBM is here to help you keep your focus where it belongs – on your patients. Contact us today to find out how we can decrease the stress of running your practice!
For Certified Registered Nurse Anesthetists (CRNAs), full practice authority is one of the most important issues when it comes to job satisfaction. According to evidence dating back to 2000, CRNAs have provided high quality, cost efficient, safe anesthesia care equal to that of anesthesiologists. But there’s a new rule on the horizon related to Veterans Administration APRNs, including CRNAs. What is this rule, and what does it mean for CRNAs?
Recently, a rule was proposed that would utilize all VA APRNs, including CRNAs, to their full practice authority. The purpose of this rule is to expand veteran access care, reducing the outrageous (and dangerous) wait times that many of our veterans are dealing with. All APRNs would be able to work to the full extent of their training, education, certification, and licensure, which is what they already do in all branches of the U.S. military and most states, plus Indian Health Services.
Reactions to the proposed rule have been mixed. The Institute of Medicine and the RAND corporation have both recommended this removal of obstacles between APRNs and full practice authority; however, even though the issue seems logical and is obviously needed, it has encountered resistance from other sectors of organized medicine.
One group that countered the proposed rule was the American Society of Anesthesiologists, but no evidence-based reasoning has been produced by any physician group for their opposition.
When it comes to understanding everything that’s coming down the pipe for 2017 (and boy, is it a lot), we make it a point to stay up-to-date on every new proposed rule and regulation. If you’re looking for a medical billing company who can handle your claims and coding, plus keep you afoot of the latest trends, laws, and policy changes, contact Medical Business Management. We’ll handle the paperwork so you can focus on your patients.
It’s a more common issue than we realize: medical professionals are sometimes asked to provide anesthesia for a patient without any knowledge of that patient’s medical history or current physical condition.
A thorough evaluation of the patient’s health history, current physical condition, and psychological state before administering anesthesia is a necessity. This has always been a requirement, but it’s especially vital to perform these assessments before each appointment when the patient is scheduled to receive anesthesia so that the agent and dose can be properly determined, as well as the techniques that should be used.
Yes, local anesthetics are generally safe when given in therapeutic doses. But that doesn’t make these evaluations any less important.
Usually, a patient is asked to complete a comprehensive health history form prior to treatment at any clinic. The medical professional who will be administering anesthesia should have a full understanding of this form so that he or she can make an appropriate plan for care.
Health history forms are largely subject to the patient’s level of awareness and honesty, which means that something can easily be left out, either accidentally or on purpose. This kind of information deficit has the potential to cause major problems when it comes to anesthesia, so it’s essential to conduct a physical assessment in order to evaluate the patient’s vital signs.
These vital signs can identify conditions that may require a change in treatment. They can also give baseline values that might be needed by the medical professional during treatment or if an emergency arises.
Your patients deserve your full attention. So what happens if you’re worried about something else, like accounts receivable or your revenue cycle? You need to call in an outside expert to manage these things for you.
That’s where we come in. If you need help with anesthesia billing, don’t waste any more time worrying about it. Contact us today!