September 5, 2007 - HMS Healthcare, PPOM, Sloans Lake Preferred Health Networks and Flora Health Network to become "Cofinity." ... Details...

What is PQRI? South Oakland Summarizes a New Medicare Reporting Initiative

June 22, 2007 - Many of our clients are asking about the new Provider Quality Reporting Initiative (PQRI), which the Center for Medicare and Medicaid Services (CMS) will launch on July 1, 2007. To help simplify things for everyone, we have provided this summary of the program and some things to think about as you consider whether or not to participate ... Details...

Write Your Representative: Congressional Members Urge CMS to Review Medicare Payments for Anesthesia Services

May 21, 2007 - Several members of Congress are sending a message to the Centers for Medicare and Medicaid Services (CMS), urging the agency to analyze Medicare payments for anesthesia services, which have been cut 8.9% in 2008. Anesthesia-related organizations across the country are asking their members to encourage Representatives to endorse the letter, which asks CMS to change the current payment formula for anesthesia to more "appropriate payment levels." Click here to access the American Society of Anesthesiologists' CapWiz action center, and send your representative an email, or find ... Details...

CMS Publishes 2007 Anesthesia Conversion Factors

January 9, 2007 - The Centers for Medicare and Medicaid Services (CMS) has published the 2007 Anesthesia Conversion Factors (CF) with geographical adjustments... Details...

Medicare to Hold Payments for Nine Days in September

September 8, 2006 - Centers for Medicare and Medicaid Services (CMS) is required to hold payments for all Medicare claims during the last nine days of September. If deemed eligible for payment, these claims will be reimbursed on October 2, 2006 without penalty... Details...

March 14, 2006 - The Centers for Medicare and Medicaid Services (CMS) has published the 2006 Anesthesia Conversion Factors (CF) with geographical adjustments. ... Details...

February 6, 2006 - The U.S. House of Representatives last week passed a revised bill (H.R. 643) providing enough funding to keep Medicare Physician Payments at the same level as 2005. Details...

Health Alliance Plan Issues Revised Anesthesia Reimbursement Policy

June 6, 2005 –  Health Alliance Plan has revised its anesthesia reimbursement policy, effective October 1, 2004.  ... Details ...

UnitedHealthcare® Changes Payment Policy

April 14, 2005 –  UnitedHealthcare® has changed the way they reimburse claims for non-participating physicians and hospitals. The change was outlined in a letter addressed to all non-participating providers dated March 2005.  ... Details ...

Michigan Medicaid Implements Fee Reductions

April 14, 2005 –  The Michigan Department of Community Health (MDCH) has implemented a 4% reduction in the 2005 anesthesia conversion factor for dates of service on and after May 1, 2005  ... Details ...

2005 AAA Conference: Group Management Education For Anesthusiasts

January 7, 2005 –  The Anesthesia Administration Assembly will present its educational conference in Colorado Springs this coming April. The annual event brings together leaders and colleagues, both clinical and administrative, to discuss current topics  ... Details ...

CMS Publishes 2005 Conversion Factors by Geographic Locality

November 26, 2004  –  The Centers for Medicare and Medicaid Services (CMS) has published the 2005 Anesthesia Conversion Factors (CF) with geographical adjustments. The chart below ... Details ...

Health Alliance Plan Releases Revised Anesthesia Reimbursement Policy

September 23, 2004 – Health Alliance Plan (HAP) has released a letter explaining its new anesthesia reimbursement policy and outlining which components of the new policy will go into effect next month.  Details ...

Health Alliance Plan Postpones New Payment Policy

September 9, 2004 – In response to the objections voiced by South Oakland Services and other anesthesia groups, Health Alliance Plan (HAP) will postpone implementation of its proposed new payment policy. HAP, one of Michigan’s largest Health Maintenance Organizations, recently announced plans to revamp its anesthesia payment methodology. Details ...

Blue Cross Blue Shield of Michigan Raises Anesthesia Conversion Factor

June 25, 2004 – Beginning July 1, 2004, anesthesiologists in Michigan will see an increase in the per unit rate for all professional anesthesia services, Blue Cross Blue Shield of Michigan (BCBSM) announced this month. Details ...

Health Alliance Plan Proposes New Payment Policy

June 25, 2004 – Health Alliance Plan (HAP), one of Michigan’s largest Health Maintenance Organizations, has announced plans to revamp its Anesthesia payment policy. Proposed changes will undergo review this summer by HAP departments, select anesthesia providers and billing agents. The expected implementation date is October 1, 2004. Details ...

CPT Changes in Anesthesia Billing and Coding for 2004

February 25, 2004 – Effective January 1, 2004, hundreds of coding additions, revisions and deletions affecting how the medical profession communicates procedures and services were made.  This article highlights those revisions which most significantly impact anesthesia and pain management providers. Details ...

Good News for Teaching Anesthesiologists

February 25, 2004 – The Centers for Medicare and Medicaid Services has issued a change governing teaching physicians.  Effective January 1, 2004 Medicare allows payment for a personally performed service when an anesthesiologist is involved with one or two concurrent residents/cases.  Details ...

CMS Publishes 2004 Conversion Factors by Geographic Locality

January 14, 2004 – The Centers for Medicare and Medicaid Services (CMS) has published the 2004 Anesthesia Conversion Factors (CF) with geographical adjustments. The national average anesthesia conversion factor will be $17.50 effective January 1, 2004, representing an average 2.6% increase from 2003 ($17.05). The median value is $17.48.  Details ...

BCBSM To Correct Problem with Fluoroscopy Rejections

November 11, 2003 - Blue Cross Blue Shield of Michigan (BCBSM) will fix the problem with its insurance code editing program, which has been rejecting fluoroscopy, a common procedure performed with pain management injections. Details ...

BCBSM Approves Intraoperative TEE Codes; Effective Date Pending

November 11, 2003 - In a meeting with representatives of the Michigan Society of Anesthesiologists, Blue Cross Blue Shield of Michigan (BCBSM) assured anesthesia providers that intraoperative transesophageal echocardiography (TEE) codes would again be reimbursed.  However, BCBSM gave no indication of when the recommended policy would go into effect. Details ...

CMS Publishes Physician Fee Schedule for 2004
announces 3.6% decrease in Anesthesia CF

November 8, 2003 - The Centers for Medicare & Medicaid Services (CMS) yesterday published its Physician Fee Schedule for the calendar year 2004. In its Final Rule, CMS announced a 4.5% decrease in the Fee Schedule for most services, along with revisions to its Anesthesia Conversion Factor (CF). Details ...

Visit SOS at the NYSSA-PGA National Conference

November 8, 2003 - South Oakland Services' Senior Management will be on-hand at the 57th Annual Post-Graduate Assembly in Anesthesiology (PGA57), December 12-16 in Manhattan. Details ...

Concerns Mount As HIPAA Deadline Looms

September 2, 2003 - In an environment reminiscent of Y2K, health care providers, payors and related service companies are increasingly concerned over what will happen to their cash flow after the Health Insurance Portability and Accountability Act (HIPAA) deadline of October 16, 2003. Details ...

Visit SOS Senior Management in Booth #417 at the ASA Annual Meeting October 11-15, 2003

July 03, 2003 - South Oakland Services (SOS) will join more than 300 exhibitors at the annual meeting of the American Society of Anesthesiologists (ASA) in San Francisco this October. Organizers expect more than 15,000 anesthesia practitioners will attend the national conference and exposition dedicated to the specialty of anesthesia. Details ...

Blue Cross Announces Increase in Michigan Anesthesia CF

June 14, 2003 - Blue Cross Blue Shield of Michigan (BCBSM) has announced it will increase the anesthesia conversion factor by two dollars across the state of Michigan, effective July 1, 2003. This indicates an approximate 6% raise in the per unit amount for all professional anesthesia services. Details...

TEE Codes Unbundled In April 18 Reversal

April 22, 2003 - The Centers for Medicare and Medicaid Services (CMS) has reversed an earlier decision to bundle intraoperative transesophageal echocardiography (TEE) with other anesthesia service or CPT codes. CMS will modify the Correct Coding Initiative (CCI) edits that have been causing claims for TEE to be rejected since April 1. The change will be implemented on July 1, 2003, retroactive to April 1. Details...

TEE Codes Bundled As Of April 1 

April 7, 2003 - Effective April 1, 2003, anesthesia providers will no longer be reimbursed separately for intraoperative transesophageal echocardiography (TEE). The Centers for Medicare and Medicaid Services (CMS) made changes in its Correct Coding Initiative (CCI) Version 9.1 that effectively bundles TEE with anesthesia service codes or other CPT codes. Details...

CMS Announces Increase in 2003 Anesthesia Payment Levels, effective March 1 

February 28, 2003 - This week, the Centers for Medicare and Medicaid Services (CMS) has announced an increase in the anesthesia conversion factor, effective March 1, 2003. The national average Medicare anesthesia conversion factor (CF) will be $17.05, which represents a 2.7% increase over the 2002 levels currently in effect (the national average CF for all other services will be $36.77, representing a 1.6% increase). Details...

2002 Conversion Factor May Remain in Place Through September

February 4, 2003 - The U.S. Senate has approved a spending bill that eliminates a significant cut in the Medicare Conversion Factor (CF) for 2003. The bill is now being considered in the U.S. House of Representatives, with action expected later this month. If the House approves a freeze, the current 2002 CF will remain in effect until September 30, 2003, by which time, many experts hope there will be new legislation to solve some of the problems in payment policy for Medicare services. Details...

Modifications in CPT Coding for 2003 Require Careful Attention to Documentation

February 4, 2003 - Modifications in the Current Procedural Terminology (CPT-2003) Codes for anesthesia and pain management make it imperative that providers keep accurate records. New codes have been added and old codes have been revised in an attempt to make coding more appropriate. In many cases, expanded CPT language results in better reimbursement. There are four major areas where modifications may change the way you fill out the anesthesia record to ensure accurate coding: arthroscopic anesthesia, thoracotomy procedures, anesthesia for hernia repairs in infants less than one year old, and daily post-op pain rounds. Details...