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Re:Anthem drops controversial new plan to cap anesthesia cov... by lr1970 on Sunday December 08, 2024 @02:14PM (#42359533)
An Anesthesiologist does not determine the duration of an operation. It depends on the type of operation, how sick the patient is and how fast or slow is the surgeon. Anesthesiologist provides anesthesia for the full duration of the surgery. You cannot blame an anesthesiologist for a surgery than runs extra two hours because surgeons need extra time. It makes no sense.
Re:Anthem drops controversial new plan to cap anesthesia cov... by tzs on Sunday December 08, 2024 @03:08PM (#42359969)
They were going to still pay for longer than normal procedures. It was just that it would have to be shown than the overtime was medically necessary.

The time they were going to allow before justification was required is the same time the Medicare uses for deciding how much to pay.

Re:Anthem drops controversial new plan to cap anesthesia cov... by lr1970 on Sunday December 08, 2024 @05:04PM (#42361044)
> was just that it would have to be shown than the overtime was medically necessary.

And then the insurance paid medical adjudicators will find it "not medically necessary". And the vicious cycle continues -- deny, delay, defend.