A couple of months ago, my wife had to go into the hospital for a procedure which required her to go under a general .. Today a got a large packet of pages .. the EOMB from Medicare for all the charges submitted.
I noticed on the list that there appeared to be a duplicate billing for a particular service … both had the same procedure code with the exception of one letter modifier .. So I called the Medicare 800 number to inquire… What a waste of time… all the person on that end could tell me what Medicare was charged…. what they approved.. and what was left over for the patient to pay.. And suggested that I called the physician office.. to get a clarification…
So I went to the best source to come to some conclusion – GOOGLE.. After some search for the meaning of the ICD10 code meant and what the two modifiers meant..
It would appear that her Anesthesia was done by a CRNA and charged for doing that … and apparently their was a Anesthesiologist – somewhere – monitoring – according to the billing code… 2-3-4 different CRNA’s and patients… and both the CRNA and the Anesthesiologist got paid the SAME amount each.
Where did we miss the boat… if you follow this billing model… we should be charging for the tech processing the Rx and we should be charging again for supervising them doing their job..
Is this because of a shortage of Anesthesiologist or is this the new model for providing healthcare ? The CRNA gets the same allowable as the Anesthesiologist… for the procedure code.. but.. the Anesthesiologist can monitor – apparently – up to at least four CRNA’s… getting the same allowable times how many CRNA’s is being monitored.
Doing a quick Google search… it would appear that Anesthesiologists make about THREE TIMES CRNA.. explains a lot !
I know that I recently read a article about the “10 best fields to get into”.. there was a number of healthcare careers listed.. and everyone of them had the word “technician” in the job title.
Filed under: General Problems
I see that I made a mistake by not going to medical school and becoming an Anesthesiologist. 🙂 Currently, I am filling rx’s for patients that do not pick them up within a week and I am forced to put them back on the shelves. Then, the patient comes in the next day and I have to fill them again. But, my company only gets one reimbursement. Then, there are the 12 rx’s the physician sent electronically and I dutifully filled and the patient came to the pharmacy and only wanted one of them and I had to put the rest in stock and my company only got paid for filling one rx. What is wrong with this picture? I know….I should have becom an Anesthesiologist! 🙂