Billing, collection and practice management for anesthesia and pain management groups.

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Billing, collection and practice management for anesthesia and pain management groups.


The information presented herein reflects general information that is current as of the date it was first published. Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.

  • What is CAQH?
    Feb. 19, 2024 – What is CAQH? CAQH stands for The Council for Affordable Quality Healthcare, Inc. and collaborates with health plans, providers, and related organizations to make the business of healthcare more streamlined and efficient. (caqh1) The CAQH Provider Data Portal is an online data repository of credentialing data. Healthcare Providers store their demographic, education and training, work history, malpractice history, and other relevant credentialing information within their own secure online platform. Providers can log in anytime from anywhere and can approve access for payers, hospitals, provider groups, and credentialing agencies. 

  • Out-Of-Network Balances- Who Gets the Bill?
    Jul. 16, 2021 – When anesthesia providers have a contract with an insurance, the insurance has a set rate that they pay per unit for each claim. This is considered processing “in-network”. However, when providers are not contracted with an insurance, but they bill a claim to that insurance, the claim is processed as “out-of-network”. This means that the insurance will pay up to what they deem “usual and customary” for the procedure or services provided. This can leave the provider receiving little to no payment on the claim, and they must then decide to either balance bill the patient or take the hit and adjust off the remaining balance. With many states moving to enforce a No Balance Bill Law, balance billing the patient may not be a choice much longer, but there is another step to take before taking the adjustment for the remaining balance.

  • Are CRNA Only Practices Becoming More Common?
    Jun. 16, 2021 – There are many reasons why some find it beneficial to have CRNA only practices. Recently a facility in Wisconsin replaced all anesthesiologists with CRNAs. What are the benefits of a CRNA only practice, and do the benefits outweigh the risk?

  • Is Ultrasound Guidance Billable for Arterial Line Placement?
    Apr. 30, 2021 – Confusion as to whether to bill for ultrasound guidance begin in 2012 when CGS Medicare published an article stating that through clarification with AMA/CPT, code 76937 – Ultrasound guidance for vascular access, would only apply to venous procedures and gave know additional information as to which codes would or would not apply to be billed in conjunction. In 2019 was amended to state that 76937 could not be billed with a full listing of procedures as stated above yet 36620 (A-Lines) was not listed suggesting that 76937 could be billed for A-Line placement.

  • The Nurse Licensure Compact Explained
    Mar. 29, 2021 – The Nurse License Compact is an interstate compact, an agreement between multiple states, put into place to resolve certain mulitstate concerns.  The license compact is similar to a driver's license compact which allows recognition and acceptance to each person's license regardless of the state they may be in or are from.

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