CIGNA to cut CRNA QZ Reimbursement by 15%

[DesiredMemberName?]

Other insurers to follow suit?

https://centercare.com/_uploads/Reimbursement-policy-updates-Jan-2023.docx

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[Anesthesia_Guy]

Excellent. Do your own cases you lazy f_u_c_k_s.

 

[Beeftenderloin]

Makes sense. I too expect to pay less for an inferior product.

 

[ambiturner]

Do CRNAs bill QZ when there is no anesthesiologist involved? Or does this only apply to cases where an anesthesiologist is ‘supervising’ >4 CRNAs? If the former this could potentially be beneficial, if not there’s now potentially incentive to get rid of the one anesthesiologist you had hanging around for show.

 

[TheLoneWolf]

Let's cut that down to 50%. Feet to the fire.

 

[Dr. Rude]

This seems like it could be a big problem for practices that do 4:1 with qz to get full billing. Am I remembering right that qk is reimbursed at half of qz so most practices that can do qz bill that?

A fair number of practices bill QZ to avoid having to sweat occasionally going over 1:4. Or not meeting all the steps of medical direction for every case and resulting consequences.

 

[nimbus]

I wouldn’t cheer any cut in reimbursement for anesthesia services. Ultimately it will trickle down to all of us.

 

[GassYous]

What happens if CRNAs supervise AAs under qz

 

[jwk]

What happens if CRNAs supervise AAs under qz

There are no provisions in CMS regulations or the laws of any state to allow that. It's absurd on it's face. It got shot down in Arizona a couple weeks ago - the only one voting for it was the sponsor of the amendment to the bill.

 

[anbuitachi]

"Additionally, as part of the R39 reimbursement policy implementation, we will administratively deny the anesthesia CPT code with the lowest base unit on claims submitted with multiple codes, and reimburse the code with the highest base unit. We will reimburse the first code submitted if the base units are equal."

highest unit ?! so nice

might be issue here. we cover crna 1 to 1.

 

[nimbus]

"Additionally, as part of the R39 reimbursement policy implementation, we will administratively deny the anesthesia CPT code with the lowest base unit on claims submitted with multiple codes, and reimburse the code with the highest base unit. We will reimburse the first code submitted if the base units are equal."

highest unit ?! so nice

might be issue here. we cover crna 1 to 1.

Whenever a procedure has multiple CPT codes, we’ve always submitted just the highest value code.

 

[dabears505]

This is nothing to cheer about. There are plenty of private groups that have physicians do their own cases, but don't have the staff for placing an md in an eye room or endo room. Qz collections keep the group viable. This is another nail in the coffin for private groups without a large hospital subsidy.

 

[anbuitachi]

This is nothing to cheer about. There are plenty of private groups that have physicians do their own cases, but don't have the staff for placing an md in an eye room or endo room. Qz collections keep the group viable. This is another nail in the coffin for private groups without a large hospital subsidy.

yes financially its bad for groups. but at same time its hard to justify inferior work for same pay. i think they are two different points.

 

[coffeebythelake]

What they should do is decrease crna comp 15% and increase other comp 15% to be net neutral. But they don't. Becauae insurance companies are evil and just doing it to bump up their bottom line