Billing question

[user69]

Is there any advantage to a hospital to have MDAs on staff instead of CRNAs? My understanding is that Medicare reimburses at the same rate for both professions, so why would a hospital have a MDA that has to be paid 3X what a CRNA makes? And the other side of that is why do MDAs make so much more than CRNAs? I have read on line that normally a CRNA being supervised by a MDA split the fee 50/50, but why is the CRNA willing to give up that 50% is they do not need to be supervised?

Follow-up question is about insurance. Is a CRNA practicing independently charged the same insurance as a MDA practicing independently in the same area?

[loisane]

This is not my understanding of how reimbursement works. I await another response from a seasoned member.

It is my understanding that medicare reimburses the same for each case regardless of who performs the anesthesia.

What a shocker if they didn't.

I have to agree with Brenna's Dad, that my understanding is that reimbursement is the same under Medicare rules. This is something AANA accomplished quite some time ago, and it has been very significant in the development of our profession.

There is a section on the AANA website that explains Medicare billing. I am sorry I do not have time to look for it now, as I am out of town. It is a complicated subject, so it helps to have sources that can break it down to understandable level.

loisane crna

[stsdoc]

Is there any advantage to a hospital to have MDAs on staff instead of CRNAs?QUOTE]

Yes, MDAs have more training and are therefore better equipped than CRNAs to deal with certain complications of anesthesia that could and do arise. Flame away.

[trakstar]

If you want to know the history of AA's, ask an AA. They were NOT created by the ASA.

The Medicare splits for MD's and anesthetists are not new. They've been around in some form since the mid-80's. And I remember when they came around that a lot of MD's did NOT like it - there were a lot of group practices around with a single anesthesiologist covering a dozen rooms with CRNA's. They were all making a ton of money and would like to have kept it that way.

Funny how a discussion that started about reimbursement deteriorates into AA bashing.

I have no intention of AA bashing. I firmly belive that most AAs are competent at delivering safe anesthesia under the supervision of MDAs. What bothers me is that an MDA stands to benefit nicely from 4 hard working AAs or CRNAs when supervised. I ask you is this fair? Before you answer think about a few things. This board has some anonymity. I know that we may both be bias to some extent towards our own professions. I also think that it is wonderful that the ASA and AAAA support each other in each others professions just like the ANA supports the AANA. I would ask you to flatter me as well as many readers in this forum with a down right honest answer. I think either medicare should decrease their reimbursement for MDAs to 25% with up to 4 room supervision or decrease the number of rooms a MDA can supervise to two or have a reimbursement based on percentage of time involvement in each particulr OR case up to 4 rooms. I think MDAs have worked long and hard to be MDs and have deserve to earn more for their training. I just think that there is better ways to utilize MDAs and be more cost effective while maintaining safe anesthesia.

[trakstar]

I have to agree with Brenna's Dad, that my understanding is that reimbursement is the same under Medicare rules. This is something AANA accomplished quite some time ago, and it has been very significant in the development of our profession.

There is a section on the AANA website that explains Medicare billing. I am sorry I do not have time to look for it now, as I am out of town. It is a complicated subject, so it helps to have sources that can break it down to understandable level.

loisane crna

Please read addendum. Thanks.

[trakstar]

Didn't mean to be insulting. There are a few people on this board that have been practicing anesthesia for over 20 years and are very informed with regards to the reimbursement rules. (not that I'm saying you aren't).

It seems that in your last post (if I am reading it correctly) that you agreed with me in saying that reimbursement for anesthesia is the same regardless of provider? Of course, I agree that it behooves the MDA to supe cases rather than perform them since they can effectively receive 200% compensation.

Sorry for the misunderstanding. I do agree and you mus understand that medicare changes are frequent and hard to understand. What was once true today might not be a month from now.

[Brenna's Dad]

Excellent stsdoc... thank you for setting yourself up for flaming!!

Perhaps you could explain exactly what complications resulting from anesthesia, physicians are better able to handle?

Again, thank you for your post!