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O R
M A N A G E M E N T
STIPENDS AND SUBSIDIES
Billing and Collecting for Anesthesia Services
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f you employ your anesthesia providers or pay them stipends or subsidies, keep in mind that the Office of Inspector General frowns on surgical
facilities that try to profit from anesthesia (tinyurl.com/a86blxj). In May
2012, the OIG issued an opinion on the so-called company model wherein
"…the ASC physician-owners establish separate companies for the purpose
of providing anesthesia-related services to outpatients undergoing surgery at
the centers" and pay anesthesia providers some portion of the revenues
while keeping the remainder.
Bona fide employee arrangements, or just having anesthesia groups bill
and collect for their services, seem to be the only sure ways to go. Any
facility engaged in the company model should seek legal counsel.
If you pay stipends or subsidies to your anesthesia group, expect transparency when stipends are requested. The anesthesia group should be able
to justify the requested sum by identifying problems with the payor mix or
services you request that are otherwise uncompensated. Stipend requests
may be somewhat difficult to quantify. In that case, consider a system of
reasonable incentives. Benchmarking on-time starts, cancellations or PONV
rates could be tied to stipend payments. Quarterly or monthly meetings to
assess the stipend payment, benchmarking and payor mix changes are an
opportunity to solidify a working relationship and ensure all parties understand and align their needs.
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— Jay Horowitz, CRNA
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | F E B R U A R Y 2013
