How the Anesthesiology Sector Is Impacted by the Rise of Telemedicine

Before the emergence of COVID-19 as a global pandemic, less than 20% of all people in the United States used some form of telemedicine. However, as the virus spread, more healthcare institutions turned to alternative ways to provide services to patients while limiting in-person visits and interactions. 


Has the rise of telemedicine affected your practice’s cash flow? Schedule a consultation to find out how you can manage your revenue cycle and adapt your practice to changing conditions.


Met with unprecedented demand, “telehealth” emerged as a more broadly available solution during the pandemic.  Throughout the past several months, this solution has evolved to meet the growing and changing needs in the healthcare industry. 

 

Telehealth for Anesthesiologists 

While there are some intraoperative uses, most of the available telemedicine options for anesthesiologists are preoperative and postoperative. Although there are very few extensive reports available on this subject, as anesthesiologists adapt to this learning curve, some of the observances of uses and requirements associated with tele-anesthesia process include:

Preoperative 

  • Video examinations to define the urgency of patients’ needs 
  • On-site nurse with the patient for tele-examination
  • Digital stethoscope tools to obtain patient vitals and visual examination of the patient
  • Discussion patient medical history

Intraoperative

  • Remote guidance of intraoperative management
  • Real-time surveillance of multiple anesthetizing sites

Postoperative

  • Recovery management
  • Rehabilitation after discharge through remote monitoring 
  • Oversight of pain management 
  • Ability to record recovery milestones 

While these actions are performed during the telemedicine process, an in-person review and physical examination still occur on the day of the procedure. Since a significant amount of the information is gathered through various remote tools before the patient comes on-site, the anesthesiology process is faster and reduces the time the patient and anesthesiologist come into contact. 

 

Evaluating Telehealth in Anesthesiology

Telemedicine does pose some privacy concerns. Patients share personal details about themselves and their medical history over a network platform, and the video examination of these patients often includes exposure of their chest. However, studies have shown that patients and anesthesiologists are either satisfied or very satisfied with the telemedicine process. 

Anesthesiology through telemedicine has benefits that reach beyond the social distancing measures brought about by COVID-19. Hospitalized patients for whom traveling to another hospital would pose significant risks, such as medically fragile infants, can now have their history reviewed, hearts and lungs examined, and have their procedures discussed remotely. Additionally, in low-income areas, local access to anesthesiology professionals is often lacking. Tele-access to these services could reduce these disparities at a much more affordable cost. 

As the processes become more efficient, tele-anesthesia has the potential to be a very positive development in providing anesthesia and surgical services when conditions call for remote care and when patients are located significant distances away from providers. 

For more information on COVID-19 updates for anesthesiologists and CRNA’s click here!

 

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MACRA 2020 Reports

MACRA (the Medicare Access and Chip Reauthorization Act) was created to help healthcare providers report data on the quality of services to reduce the burden of healthcare costs on the taxpayers. MACRA reports hundreds of measures, but not all apply to anesthesia providers and groups across the board. 

We have compiled the relevant measures that apply to anesthesia practices and help these providers meet the required reporting thresholds. With this information, anesthesia providers and groups can make strategic decisions on what measures to apply to their practice, and stay up to date on how to be successful in this changing environment. 

Download a copy of the 2020 anesthesia MACRA reports here.

COVID-19 Updates for Anesthesiologists and CRNAs

As the United States grapples with the COVID-19 pandemic, many anesthesiologists and CRNAs are struggling to understand how this unfolding situation will affect their practice financially and logistically. A pair for updates from The Centers for Medicare & Medicaid Services (CMS) provides critical updates that affect physician supervision requirements and accelerated reimbursements.

If you have questions about how these updates affect your practice during these updates affect your practice, contact us at (800) 477-4544 for a free consultation.

CMS Temporarily Suspends Physician Supervision Requirements for CRNAs

The Centers for Medicare & Medicaid Services (CMS) has temporarily suspended physician supervision requirements for Certified Registered Nurse Anesthetists (CRNAs)—an action that the American Association of Nurse Anesthetists (AANA) deems a critical step for CRNAs to serve the U.S. healthcare system more effectively during the COVID-19 pandemic.

Read More on The American Association of Nurse Anesthetists Website

Accelerated and Advance Payments Program For Providers and Suppliers

The Centers for Medicare and Medicaid Services (CMS) has released a fact sheet explaining how it intends to put money directly into the hands of professional clinicians and hospitals whose surgical caseloads—and income—have plummeted due to the coronavirus (COVID-19) outbreak. According to the fact sheet, “CMS is authorized to provide accelerated or advance payments during the period of the public health emergency to any Medicare provider/supplier who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications.“

Read More on the Emergency Program Fact Sheet

Thank a CRNA this Week!

Medical Business Management would like to take the time to honor all CRNAs (Certified Registered Nurse Anesthetists) during National CRNA Week for their hard work and efforts. The purpose of National CRNA Week isn’t just to celebrate all CRNAs around the world but to also educate the public on what their work entails.

What do CRNAs do?

CRNAs are medical professionals who are responsible for safely providing anesthesia to patients. They assist healthcare professionals such as dentists, surgeons, and physician anesthesiologists and work in many different settings like hospitals, dental, podiatry, and plastic surgery clinics.

A CRNA’s job is more complex than just administering anesthesia. They have to evaluate the patient to determine the amount of anesthesia to administer, prepare the operating room with the appropriate tools, and monitor the patient throughout the procedure in addition to giving anesthesia. The patients look to them during recovery, and they can count on their CRNA being right by their side, literally. CRNAs have a lot of responsibility and the patients’ lives are in their hands. That is why they are some of the most respected and admired healthcare professionals. 

Medical Business Management (MBM) is a full service claims, billing, and medical practice management company.  Learn more about us here.

 

HICN: The End of an Era

HICN

The Transition Period is Over!

For 2020, it’s out with the old, and in with the new. Starting January 1st, 2020, CMS will reject any and all claims submitted with the old, the HICN (Health Insurance Claim Number), and will only accept them submitted with the new, the MBI (Medicare Beneficiary Identifier). Hopefully, you’ve been hearing about this change for some time and are already accustomed to submitting your data exchanges with the new MBI. If you’re not, here’s a couple of points you should definitely take note of going into the new year. 

MBIs are all unique and randomly generated. The numbers don’t correspond to any patient information, and the characters are all non-intelligent. 

MBIs: 

  1. Are 11 characters in length, for example: 1EG4-TE5-MK72
    • The MBI’s 2nd, 5th, 8th, and 9th characters will always be a letter.
    • Characters 1, 4, 7, 10, and 11 will always be a number.
    • The 3rd and 6th characters will be a letter or a number.
    • The dashes aren’t used as part of the MBI.
    • Consist of only uppercase letters and numbers, excluding the letters S, L, O, I, B, and Z to eliminate confusion.
  2. Are clearly different than the HICN and RRB (Railroad Retirement Board) numbers
    • If you submit a claim with an RRB number instead of an MBI, there should be an alert that is returned on the HETS eligibility transaction response. 
  3. Should be protected by Medicare beneficiaries as though it was their Social Security Number

 

You will use MBIs going forward for all beneficiary issues regarding billing, eligibility status, and claim status. There are a few exceptions where you will still be able to use the HICN/MBI: 

  1. Appeals & Adjustments
  2. Retrospective Reporting
  3. Fee-for-Service claim exceptions:
  4. Appeals, Audits, Claim Status Query, Span-Date Claims, Incoming Premium Payments
  5. Private payers submitting non-Medicare claims

 

All of your patients should have their new Medicare cards and MBIs already, but if they don’t, providers still have a way to help beneficiaries get their MBIs – using the secure web portal with MAC (Medicare Administrative Contractor).

  1. Providers/Suppliers can use a MAC portal to look up any beneficiary’s MBI with the following information: 
    • Patient SSN, Last Name, First Name, and Date of Birth 

This transition may seem like a pain in addition to everything else that has to changeover for 2020, but the system will ultimately be beneficial in the long run. Removing Social Security Numbers from Medicare cards and systems helps to protect the 61 million beneficiaries across the United States from taxpayer fraud and identity theft. 

Contact us today if you still have questions. We want to help you succeed.

What is MAC Anesthesia?

MAC stands for Monitored Anesthesia Care. MAC is not necessarily a type of anesthesia but more of a
style of anesthesia.

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.

Sedation With MAC Anesthesia

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 Post-Procedure Care

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.

Did You Know It’s CRNA Week?

crna

Every anesthesia practice depends on a team effort to serve its patients. One key part of this team effort is a practice’s Certified Registered Nurse Anesthetists (CRNAs), who perform essential (and often thankless) tasks to help patients with their healthcare needs.

This week, it’s National CRNA Week – a time to commemorate the hard work CRNAs all over the country perform on behalf of their valued patients.

What Does a CRNA Do?

A CRNA is a nurse who specializes in providing anesthetic care to a patient. CRNAs have graduate-level education and board certification in anesthesia. It is estimated that across the country, CRNAs administer roughly 34 million anesthetic procedures each year.

A CRNA works closely with anesthesiologists, other CRNAs, or physicians – such as surgeons – providing medical direction to the nurse. The amount of independence a CRNA has varies by state, but most are capable of handling anesthetic procedures with minimal supervision or direction.

If you’ve ever had surgery, chances are a CRNA was involved. The amount of dedication it takes to go through that much schooling – much of it complex and advanced – is a testament to how much care your average CRNA puts into his or her job.

(In the military, most anesthetic care is provided by CRNAs. They’re often some of the first providers for our service men and women after injury.)

Showing Appreciation to CRNAs

This week is the time to take note of what CRNAs do for practices all across the country, and how patient care is better because of their presence.

For more information, check out the official Facebook page of the American Association of Nurse Anesthetists. Also, don’t forget to recommend a top-performing CRNA for annual awards from the AANA Foundation. Nominations are due by March 31, 2016.

Be sure to thank a CRNA this week as we celebrate this honored profession and these dedicated professionals.

Pros of Outsourcing Your Medical Billing

icd 10

Outsourcing your medical billing and coding can be a great choice for your practice. The fact that you can expect an immediate 5 to 15% increase in the amount you collect may be enough to make you choose outsourcing over in-house billing.

However, if you are still on the fence, Medical Business Management wants to share some of the other benefits of outsourcing your medical billing and coding.

Staffing Issues are Never a Problem

If your practice has a high staff turnover then it will negatively impact your medical billing process and cause your revenue to suffer. When you outsource your medical billing you solve that problem.

Furthermore, when you outsource you don’t have to keep a dedicated billing specialist on your staff, which saves you money. You don’t have to worry about paying for training, salary, or insurance costs.

In short, it is much less expensive to outsource your medical billing than it is to hire a billing department for your practice or hospital.

Outsourcing is Easy and Convenient

When you outsource your medical billing, the billing company takes care of all the medical coding, data entry, claim filing, payment posting, follow-up and statements. They generally charge you a fee that is a percentage of the collected amount. Your staff doesn’t have to worry about this process and can devote their time and energy to caring for your patients.

Have a claim get denied? Medical Business Management will take care of that too!

We will take care of appealing and resubmitting any claims that are wrongly denied. We will also handle collections and pursue accounts that are past due.

Finally, your practice will not have to purchase expensive software, pay for network installation, and then have to likely pay for training on its use.

Choose the easy and convenient solution: Outsource your medical billing and coding to Medical Business Management!

ICD-10 is Rolling Out in October

ICD-10 is the new medical coding system that will be rolling out in October of 2015. There are over 60,000 new diagnosis codes alone! Add in the thousands of new procedure and treatment codes and you may start to feel a bit overwhelmed.

Errors in coding could slow down your reimbursement process considerably, causing you to face penalties or make you miss payments entirely.

If your practice is not fully prepared for ICD-10, then talk with our expert coders. At Medical Business Management, our coders have been thoroughly trained on the new coding system and are ready to implement it for your practice, ensuring you are ready for the big change.

Is Outsourcing Right for Your Practice? Call Medical Business Management Today!

If you are looking for an easy and convenient medical billing process, contact Medical Business Management today!

Our highly trained staff of medical coders and billing specialists are ready to make your practice as efficient and successful as possible.

Bundled Payments

There are a number of developments occurring to implement national healthcare and central to the remittance scheme is bundled payments. Other names for bundled payments are; episode based payments; evidence based case rate, global bundled payments and package pricing. I like bundled payments.

Many healthcare reformers believe that the solution to the “fee for service” model, which rewards physicians for performing activities or services, is to “bundle” payments around a particular health problem. This is not a new idea. Medicare proposed and implemented a demonstration project to bundle payments for heart bypass surgery in 1990. That project showed that bundled payments could work well (for heart by-pass surgery). The benefits were to reduce costs, patients had better survival rates, and shorter hospital stays were part of the results.

So, why hasn’t there been a wider acceptance of these ideas, and adoption of the concept across a number of other specialties? There are reasons, but the largest one is to determine how the bundled payment will be divided in a fair and equitable manor among the multiple providers for a single episode of service. The second reason is the difficulty of “standardizing” an episode of service.

Think of this, the grocery store where you shop is paid $150 for each full buggy (a patient’s episode of services). Each item in the buggy represents a healthcare service or activity by a provider. The grocery store receives the bundled payment and now must divide the $150 and pay it to each provider of service.

Do you think that there will be a few broken eggs and a lot of spilled milk!

New Year and expected Healthcare changes

Welcome to MBM web site and we wish you a happy and prosperous 2011. I wonder what will happen to the health care industry this year?

At 12 o’clock today (Jan 5, 2010) the 112th Congress will be “called to order.” Surely their agenda will include reductions in government spending. In my opinion, that should be their whole agenda.

In the early 1990s when our company was small and struggling, we operated by borrowing money. Today, we have a balanced budget, we don’t borrow money and we are not struggling. The US government began deficit spending in 19xx and continues to borrow and continue to struggle at a more desperate rate. The recent extreme deficit spending by the 111th Congress seems to have skewed our national priorities of life, liberty and the pursuit of happiness.

Meanwhile, the lame-duck Congress did pass a one-year-Medicare pay-fix that was signed by President Obama before January 1, 2010. This legislation averted the looming 24% pay cut for physicians and non-physician providers. It represents “breathing time,” and a time for the new Congress to begin a rational and cost effective approach to “control” health care spending.

How the Anesthesiology Sector Is Impacted by the Rise of Telemedicine

Before the emergence of COVID-19 as a global pandemic, less than 20% of all people in the United States used some form of telemedicine. However, as the virus spread, more healthcare institutions turned to alternative ways to provide services to patients while limiting in-person visits and interactions.  Has the rise of telemedicine affected your practice’s […]

MACRA 2020 Reports

MACRA (the Medicare Access and Chip Reauthorization Act) was created to help healthcare providers report data on the quality of services to reduce the burden of healthcare costs on the taxpayers. MACRA reports hundreds of measures, but not all apply to anesthesia providers and groups across the board.  We have compiled the relevant measures that […]

COVID-19 Updates for Anesthesiologists and CRNAs

As the United States grapples with the COVID-19 pandemic, many anesthesiologists and CRNAs are struggling to understand how this unfolding situation will affect their practice financially and logistically. A pair for updates from The Centers for Medicare & Medicaid Services (CMS) provides critical updates that affect physician supervision requirements and accelerated reimbursements. If you have questions about how […]

Thank a CRNA this Week!

Medical Business Management would like to take the time to honor all CRNAs (Certified Registered Nurse Anesthetists) during National CRNA Week for their hard work and efforts. The purpose of National CRNA Week isn’t just to celebrate all CRNAs around the world but to also educate the public on what their work entails. What do […]

HICN: The End of an Era

The Transition Period is Over! For 2020, it’s out with the old, and in with the new. Starting January 1st, 2020, CMS will reject any and all claims submitted with the old, the HICN (Health Insurance Claim Number), and will only accept them submitted with the new, the MBI (Medicare Beneficiary Identifier). Hopefully, you’ve been […]

What is MAC Anesthesia?

MAC stands for Monitored Anesthesia Care. MAC is not necessarily a type of anesthesia but more of a style of anesthesia. 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, […]

Did You Know It’s CRNA Week?

Every anesthesia practice depends on a team effort to serve its patients. One key part of this team effort is a practice’s Certified Registered Nurse Anesthetists (CRNAs), who perform essential (and often thankless) tasks to help patients with their healthcare needs. This week, it’s National CRNA Week – a time to commemorate the hard work […]

Bundled Payments

There are a number of developments occurring to implement national healthcare and central to the remittance scheme is bundled payments. Other names for bundled payments are; episode based payments; evidence based case rate, global bundled payments and package pricing. I like bundled payments. Many healthcare reformers believe that the solution to the “fee for service” […]