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Blog posts by molly-johnson

Virtual Visits: Providers Grapple with Telehealth Issues

We’ve come a long way since the days when the milkman would make his deliveries at the door and the doctor would make house calls, black bag in hand. Now, we order our goods online and we can even see our healthcare professional via the latest telecommunications technology. Americans love convenience, and it is certainly […]

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Aetna to Stop Physical Status Payments

According to an April bulletin published by Aetna, the payer will no longer reimburse additional unit value(s) for anesthesia physical status (PS) modifiers, effective July 15, 2024. Aetna gave as a reason for the decision its desire to align with similar Medicare guidelines. It should be noted that this change will only affect Aetna’s commercial […]

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Medicare Advantage and Part D: CMS Issues Final Rule

We recently brought an alert dealing with allegations against Medicare Advantage (MA) to the effect that MA plans were more prone to deny claims or delay payments when compared to Medicare or third-party payers. Medicare Advantage is back in the news—but, this time, for another reason. Last week, the Centers for Medicare and Medicaid Services […]

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Navigating the Anesthesia Manpower Shortage

There is clearly a shortage of anesthesia providers in the country today. This a a result of a variety of factors including the pandemic, dramatic increases in the number of anesthetizing locations and provider lifestyle choices. According to various sources, by 2033, the anesthesiology workforce may experience a shortage of approximately 12,500 anesthesiologists, representing nearly […]

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The Meaning of Consent: The Government Provides New Clarification

In the opening lines of Pink Floyd’s trippy hit, Comfortably Numb, the doctor instructs the patient to provide a response, saying: “just nod if you can hear me.” While not an exact example of what the medical industry means by “informed consent,” it does help us to think about what that term means. What are the […]

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Fading Away: Anesthesia for Chronic Pain

It was one of those end-of-an-era moments. Standing in the well of the House, before a joint session of Congress, was the “American Caesar,” General Douglas McArthur, bidding farewell to the nation after 52 years of service. First in his class at West Point, winner of the Congressional Medal of Honor and Military Governor of […]

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Taking Advantage: Sending a Message to Medicare Advantage

We’re supposed to play by the rules but not everybody does. That’s especially disappointing when that person works for the government. Recently, a former state insurance commissioner pleaded guilty to healthcare fraud. How ironic—the very person entrusted with safeguarding the consumer against insurance fraud goes on to engage in a $2.5 million scheme involving false […]

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Can a Smaller Practice Survive? The Anesthesia Question of the Day

In this era of mergers and aggregation, anesthesia practices nationwide are contemplating their futures, and many are struggling with the notion that only mega-practices survive. Is it possible to maintain a focused niche practice that only provides services to one facility or a narrowly defined market or are such practices dinosaurs doomed to fail or […]

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Impact of Improved PFS Conversion Factors

Last week, we sent out a special alert, which included news that the U.S. Congress had essentially halved the Medicare Physician Fee Schedule (PFS) conversion factor reduction for 2024, meaning there should be more money coming your way in Medicare payments than previously expected for this year. For your Medicare EOBs for services performed on […]

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