Billing Considerations

Anesthesia Billing

Anesthesia Start time is 0-5 minutes before in room time
Starts when the anesthesiologist starts monitoring, usually after a sedative is given
If the time is longer than 5 minutes a note should be made explaining why
Anesthesia end time is up to 10 minutes after case
If the monitoring is longer than 10min after exiting room, vitals should be added to the chart and a note with an explanation for prolonged monitoring

Cash/Private Pay

There is a Cash/Private Pay box (Under Ken Sacks' mailbox) in the anesthesiology office
Please put Cash/Private Pay cases, SMS cases, research cases, and cases with no insurance in this box
Look at the face sheet for every case to see the form of payment to decide to put in the regular bill box or Cash/Private Pay box

Credit given for specific calls/procedures/scenarios

Holiday Call Credit

July 4th, Thanksgiving Day, Christmas Day, New Year’s Eve, and New Year’s Day are eligible for Holiday call credit
OB and First Call will receive a bonus of 5 hours in addition to

the stipend the shift would normally get.
Second Call will receive a bonus of 1 hour in addition to the

stipend the shift would normally get.
Third Call gets 30 minutes.

Anesthesia in Charge (AIC) Credit

Monday to Thursday
- Credit for running the schedule during the day 15 minutes
- Credit for making the next day schedule 15 minutes
- Total credit for “a” and “b” is 30 minutes
Friday
- Credit for running the schedule Friday 15 minutes
- Credit for running the schedule Saturday and Sunday
  
  30 minutes
- Credit for making Monday’s schedule 15 minutes
- Total Credit for “a”, “b”, and “c” is 60 minutes
- If the Monday is a Holiday (ie Memorial Day) you get
  
  additional 15 minutes For being AIC on Monday. That
  
  would give you a total of 75 minutes

WeekDAY (Monday through Friday) Call Credit

First Call will receive 3.0 hours credit per 24 hours worked
- If you take over someone’s First Call then you get their Call credit of 3.0 hours
- It is up to the two parties involved to followup with the billing company to assure that the credit is correctly applied
OB Day Call will receive 1.5 hours credit for a twelve hour shift of 7am to 7pm
OB Night Call will receive 4.5 hours credit for a twelve hour shift of 7pm to 7am (following day)

WeekEND (Saturday & Sunday) Call Credit

First, Second, & Third Call
- If you cover your own call then you will receive 3 hours for First call on Saturday or Sunday. No credit for Second or Third call on the weekend.
- If you cover someone else’s call, you will receive 3 hours from the group for the First Call and 2 hours from the anesthesiologist you are covering. For Second Call you will receive 1-hour credit from the anesthesiologist you are covering. For Third call you will receive 1/2-hour credit from the anesthesiologist you are covering.
OB Call on Saturday, Sunday, or Holidays will receive 8.0 hours credit per 24hrs worked

OB Call Credit:

C-sections are billed as regular cases just like in the Main OR.
Labor Epidurals are billed as 2 hours. Please see the OB section for how shared Labor epidurals are handled.
- If the patient delivers before 07:30 then the full credit goes to the previous anesthesia, unless the new anesthesiologist had an active intervention.
- However, the two anesthesiologists involved may make any arrangement they wish. It is your responsibility to convey this information to the billing company and our secretary.
If you are called to place an epidural from the Main OR you get 30 minutes and the OB anesthesiologist gets 30 minutes to maintain the epidural. The OB anesthesiologist who is present for the delivery gets 1 hour.
If the previous OB anesthesiologist stays past the end of his shift (7am or 7pm) to place an epidural, the credit is 30 minutes. The current OB anesthesiologist gets 30 minutes for maintaining the Epidural.
If you are called to replace a non-functioning epidural (for labor or pain control) you are credited for 30 minutes.

VBAC/TOLACs:

The current department policy is a 1.0 hour credit applies if you are called by AIC to cover AND have to drive in from home (must meet both criteria)
The credit does NOT apply if:

The 1 hour credit is intended to compensate an individual for their time to drive in and cover TOLAC while C/S finishes who otherwise may not get any compensation.
Please submit a billing sheet to ABEO with the following info:

Proctoring credit:

Each Anesthesiologist will bill for the time they are proctoring. This means both the anesthesiologist and proctor get credit for case time.

SCOP Credit:

SMS Credit: 1 hour credit for egg retrievals

Cardioversions: 30 minutes

TEE with or without cardioversion: Billed as the actual anesthesia time

Pain Service reimbursement

Post Op pain Management and Blood patches

Placement of Thoracic Epidural outside of Main OR (PACU, ICU, PCCU, etc) credit is 1 hour
Placement of Lumbar Epidural outside of Main OR (PACU, ICU, PCCU, etc) credit is 45 minutes
Daily Thoracic epidural management, which includes all patient’s pain management, and daily pain management progress note in EPIC; credit is 30 minutes
Daily Lumbar epidural management, which includes all patient’s pain management, and daily pain management progress note in EPIC; credit is 15 minutes
Epidural Blood patch, which includes proper consultation note and procedure note within anesthetic record; credit 1 hour
Rescue Blocks on floor: 30 minutes during the week, 45 minutes on the weekend

BAYSIDE ANESTHESIA MEDICAL GROUP