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O P H T H A L M O L O G Y
CRNAs for pain management procedures in 2011, only
to have CMS reverse the policy change a year later.
There's still a lesson to be learned in Noridian's
oversight, says Dan Simonson, CRNA, MHPA, chief
anesthetist and managing partner at the Spokane
(Wash.) Eye Surgery Center. He claims the company's
lower-level support staff told concerned providers
that the policy change was planned, and that they'd
have to accept it. "How did this mistake get through
their system, and why were the support personnel so
sure it was correct?" he asks.
That shows the importance of maintaining good
relationships with the carrier medical directors at
your largest insurers, says Mr. Simonson. "You don't
have to be satisfied with the response from low-level
employees on matters of this importance," he adds.
"Medical directors of insurance companies are usually the 'court of last response' on denials, but
because they are providers themselves, they're often
far more knowledgeable and reasonable than the
company's administrative staff."
— Daniel Cook
J A N U A R Y 2013 | 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
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