Q. In evaluating a practice opportunity what questions or data should I be requesting from the practice?

A. To properly evaluate a potential anesthesia practice for private practice, or for employment salary package negotiations you should ask to see a period of practice reports that outline the following clinical data elements: Total number of surgical cases performed that required anesthesia, a break down of the different types of surgical procedures such as a percentage of orthopedic, general surgery, urology, ophthalmology, and OB procedures. Understand how anesthesia is currently being provided/delivered -anesthesia care team, solo anesthetist, solo anesthesiologist, group practice of providers, individual providers, etc. Total number of operating rooms utilizing anesthesia, requirements if any for anesthesia to be present in the GI / Endoscopy lab, and OB requirements and involvement in labor pain management. In addition to this clinical data, demographic/patient accounting data should also be provided and include items such as a listing of managed care plans the facility is associated with, patient volumes by payer or an overall payermix, as well as identifying if any package pricing that currently includes anesthesia professional services is in force. Such an agreement would preclude you from separately billing a payer for your professional services.

Q. How are we certain we are maximizing CRNA reimbursement within our facility?

See Answer.

Q. What is the necessity of obtaining an NPI -National Provider Identifier?

See Answer.

Q. Does an entity as well as an individual provider need an NPI?

See Answer.

Q. What does the term "most favored nation" mean as it appears in many third party payer reimbursement agreements and participation agreements?

See Answer.

Q. What is an RFP?

See Answer.

Q. Does it make any difference if I select CPT-4 codes from the Surgical or Anesthesia Sections?

See Answer.

Q. Since the Medicare Modifier -QS is not valid for actual reimbursement calculation, does it really need to be used?

See Answer.

Q. How long will it take to develop a cash flow from a new practice opportunity?

See Answer.

Q. I have graduated from Anesthesia School, but have not taken my certification examination, can I still bill for my services since I have completed my required anesthesia program?

See Answer.

Q. In evaluating a practice opportunity what questions or data should I be requesting from the practice?

See Answer.

Q. I plan to do all of my own procedure and diagnosis coding, -CPT-4 and ICD9-CM coding) is this a good idea?

See Answer.

Q. Is it necessary to have type of contract with a facility/hospital before I commence providing anesthesia services?

See Answer.

Q. Why would I use an ABN-Medicare Beneficiary Advance Benefit Notification document?

See Answer.

Copyright 2006 BCS, Incorporated All Rights Reserved. All materials here not otherwise noted, are the sole property of BCS, Incorporated and Lee S. Broadston. Downloading is not permitted without written permission from BCS, Incorporated prior to publication.