Re:How Being a Doctor Became the Most Miserable Profession
by FireBeyond on Thursday April 17, 2014 @12:48PM
(#7604698)
"If I place an epidural in Medicaid pt, I get paid something like $36 for the placement, and I don't get a penny for watching this pt for next 18 hours."
Wuh? I'm not a physician. But I do work for an ambulance service. And my day job has involved working with insurance reimbursement algorithms for Hospital and Insurance Administrators.
But "$36 for epidural and not a penny for the next 18 hours?"
You might want to look into that. Medicaid allows a Maximum Fee of $1.16/minute for an anesthesiologist's time.
"Essentially, hospitals will be reimbursed at $669.90 for the epidural procedure performed in the hospital setting; whereas, in office setting, after removing the portion designated for the physician professional fee, office practice expense will be reimbursed at $30.28 to $34.36 a whopping 2,315% to 2,668% with SGR cut and 1931% to 2312% without SGR cut more in the hospital setting."
Yes, epidurals are cut - but under what circumstances are you monitoring a patient bedside for 18 hours in a non-hospital setting?
And for every one of these examples, there's a flip-side:
Wisdom teeth under general anesthesia.
"Hi, I'm Mr X and I'll be your anesthesiologist today. How you doing? Now, to confirm, no allergies, right? And it says you weigh 180lb? Great, see you in theater!"
For about 90 seconds. Now, I know the principles of anesthesia, though I'd never claim my knowledge was within orders of magnitude of that of a specialist, but I routinely perform RSI for ET intubation, and I know all about "the charge isn't for the time, it's the knowledge", but nonetheless.
Wuh? I'm not a physician. But I do work for an ambulance service. And my day job has involved working with insurance reimbursement algorithms for Hospital and Insurance Administrators.
But "$36 for epidural and not a penny for the next 18 hours?"
You might want to look into that. Medicaid allows a Maximum Fee of $1.16/minute for an anesthesiologist's time.
"Essentially, hospitals will be reimbursed at $669.90 for the epidural procedure performed in the hospital setting; whereas, in office setting, after removing the portion designated for the physician professional fee, office practice expense will be reimbursed at $30.28 to $34.36 a whopping 2,315% to 2,668% with SGR cut and 1931% to 2312% without SGR cut more in the hospital setting."
Yes, epidurals are cut - but under what circumstances are you monitoring a patient bedside for 18 hours in a non-hospital setting?
And for every one of these examples, there's a flip-side:
Wisdom teeth under general anesthesia.
"Hi, I'm Mr X and I'll be your anesthesiologist today. How you doing? Now, to confirm, no allergies, right? And it says you weigh 180lb? Great, see you in theater!"
Bill:
"Pre-operative anesthesiologist consultation: $662"
For about 90 seconds. Now, I know the principles of anesthesia, though I'd never claim my knowledge was within orders of magnitude of that of a specialist, but I routinely perform RSI for ET intubation, and I know all about "the charge isn't for the time, it's the knowledge", but nonetheless.