How are you all getting reimbursed for office-based anesthesia? It seems that most payers won’t cover anesthesia equipment and supplies in the office setting. How do you go about getting paid for these items? Do you negotiate with payers to cover these costs? Or do you get a stipend from each surgeon?
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Are u a solo practitioner? It depends on how things are organized. Most places don't provide stuff. You bring the supplies and equipment. It's part of your fee. You provide a service to the surgeon and you negotiate.
I work for a large group with a growing mobile practice. Part of what fee, though? We’re not required to charge surgeons a fee, that I’m aware of, and most aren’t willing to pay one. They would rather take patients to the ASC than pay us for procedures in the office.
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Hopefully this is self pay or you get great $ per unit. It's economics. Figure out your expected collections and your expected fees. If it makes financial sense then go for it. If it doesn't then you need to negotiate a stipend for the convenience of providing office based anesthesia. There are too many unknowns to make anythjng more than a generic comment.
For the supplies it generally cheaper to buy directly from the manufacturer or second hand like ebay? For instance those mcgrath VLs handles are $1250 through the medtronic reps but I see them double that for used on ebay.
I'm in the market for a propofol infusion pump myself for future dental office work.
I'm in the market for a propofol infusion pump myself for future dental office work.
For much of our office based services, anesthesia is a flat-rate line item that patients pay for out-of-pocket (think cosmetic plastics or fertility). Every couple years we ask the surgeons to increase that rate, commensurate with inflation and equipment/supply cost increases. These days, we’re more in the driver’s seat because these offices know that it’s not easy to find someone else to provide anesthesia services.
Most office based is self-pay. A couple pieces of advice:
- Get payment before doing the case
- I billed a flat rate for first hour then in 15 min increments. Case went >5 min over and I billed for the full 15 minutes
- Make sure that surgeon/dentist understands that you need a minimum number of hours of work. No bueno to show up and find out that 1/2 the days work disappeared
U gotta be carful over billing if it’s a lot. (Not that you yourself will do it). Just giving an example.
One of my former partners wife has ivf. Self pay. The anesthesiologist billed from preop an extra 15 min before they went into the room. Padded another 15 min in recovery. He shot photo of clock when interview took place.
If u are with savvy patient or patient family member who knows anesthesia billing times. And u don’t time if appropriate. You will get nailed. This went to the state board! Over $150!!! The anesthesiologist ended up having to refund my buddy the before fee or risk medical reprimand for illegal billing. Plus lawyer fees. My buddy this dude by the balls.
That's so petty.
Someone took a picture of the anesthesiologist entering the Pre-op area at a specific time? That's not legal in most states (and not admissible in court). Or they took a picture of the clock by itself? Can't imagine that's enough evidence to prove that was the exact time the anesthesiologist showed up.
Buddy is anesthesiologist also. Yes anesthesiologist vs anesthesiologist.
It was checkmate the the anesthesiologist when it was about to go to medical board for review. Pic with him interviewing spouse with clock in background. Yes it was a game for my buddy. Considering the spouse who wanted the baby was rad onc doc making 900k.
Doesn’t matter if it’s admissible or not. The medical board operates on its own by laws. Remember the lady anesthesia doc who was recorded illegally in Virginia and got nailed in malpractice lawsuit for saying stuff.
Moral of story. Don’t fudge numbers in self pay patients per 15 minutes.
It's illegal in most states to photograph or videotape someone without their consent. They broke the law by doing that (assuming it is one of those states) and would lose any open-and-shut court case (fine, misdemeanor, possible civil suit for defamation). It does matter. Most medical boards aren't going to side with someone whose only evidence is illegally obtained.
Your friend did not break any laws. He didn't bill an insurance company fraudulently. With self pay, you can make up whatever rules you want. You can tell a patient that your billing starts when you first meet the patient. As long as they know that ahead of time, you're golden. There is no law against that. Just like when the plumber shows and knocks on your door. They can say that is when they start billing their hourly rate.
Your friend did not break any laws. He didn't bill an insurance company fraudulently. With self pay, you can make up whatever rules you want. You can tell a patient that your billing starts when you first meet the patient. As long as they know that ahead of time, you're golden. There is no law against that. Just like when the plumber shows and knocks on your door. They can say that is when they start billing their hourly rate.
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Doesn’t matter. You want to go ur license on the line for billing fraud. It will open up a can of worms for all your medical records.
Both docs are a holes. I know them both. So one a hole vs another a hole.
If that tells you the context of how this happened. Neither would give an inch. Both docs do not work with each other. I happen to work with both docs!! I just love watching drama unfold. Over what amounts to what both do them make in less than one hour. …the kid who happened to be born from ivf is same age as my daughter. Lol.
Medical boards do not take kindly with lying doctors. Be carful. That’s all I’m saying. The doc already threatened to go to the news. It’s serious stuff. And it’s not illegal to go to the news. Your personal reputation is at stake.
I don't do cash pay. We are only allowed to click Anes Start at my institution and it must match up with In Room time, so doesn't apply to me.
What does matter is that it is illegal is most states to photograph and/or videotape someone without their consent. I had a family member do it once to me and a RN in the Pre-op area. RN made him delete the video immediately and almost called security to escort him out. It is illegal, plain and simple, and should never happen in a healthcare setting.
Your "buddy" should have called security and filed a police report if they refused to delete the video on the spot. This will happen to everyone in the course of their career.
Lol. Rad onc lady was friend of the gynecologist.
Anesthesia would have lost an easy cash cow.
Again. Moral of the study. Don’t overbill. These guys were making a killing anyways. Greed has no end.
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It is NOT illegal to photograph people without their permission in public places. In private places, it's up to the owner of the property. You're confusing recording audio i suspect.
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I’m an amateur photographer for some time now and while I really don’t photograph people, at least easily identifiable people, it’s prudent to know the law. Abolt is correct. In general, it’s not illegal to photograph anyone unless there’s a reasonable expectation of privacy in the US, unless you’re doing it for nefarious reasons, like stalking. That is not true in many other countries. For the most part, outside of a bathroom, etc. if you’re in public, you’re fair game. As for taking photos of someone in a private location, like a hospital or building, the owner/manager would have to tell you to stop. I would guess most hospitals have this as a policy, ours does and it’s posted in preop, post op, etc. However that’s still not illegal, just an invasion of privacy. One could call security or the police to have you removed if you refused to stop or leave, but that would be for trespassing. You’d have to sue the person who took your photo in civil court. I suppose a good shark could try to argue invasion of privacy and emotional damages. If they never published the photo, I’m not sure you could prove damages. I’m not sure the police would trespass them either if they stopped after you asked and simply refused to delete the photos. Probably not worth finding out, but if Karen goes to 11 screaming and carrying on, citing law that doesn’t exist, etc. I can see someone saying,”Ok, let’s do this.” People do this to the police and sue them for unlawful arrest, violation of their civil rights, etc.
Not sure if it makes a difference, but the vast majority of office-based procedures we provide anesthesia services for each month (for urologists, gyno, plastics, ENT, vascular, and dental) are billed to insurance - both government and commercial payers.
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Just call it art.
"Spying" Artist Wins Privacy Case - artnet News
A Supreme Court rule in favor of photographer Arne Svenson, who photographed his neighbors without consent, brings troubling news for privacy advocates.
