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Anesthesiologist Assistants (AAs) always work under the direction of anesthesiologists�to develop and implement anesthesia care plans. (AAAA)
The American Board of Anesthesiology (
Actual Job
Are fully funded and not contingent on anything such as funding or a contract signature. "Actual" Jobs just need the right candidate. "Actual" Jobs, however, may have a start date in the future.
All Anesthesiologist
All anesthesia services are personally performed by physician anesthesiologists. No nurse anesthetists (CRNAs) or anesthesiologist assistants (AAs) are present.
Only Certified Registered Nurse Anesthetists (CRNAs) perform anesthesia services. There is no involvement of an anesthesiologist in any way. All CRNA anesthesia practices are more common in rural areas.
Anesthesia Providers
Anesthesiologists (Physician specialists in anesthesiology), Certified Registered Nurse Anesthetists (CRNAs) or Anesthesiologist Assistants (AAs)
Anesthesia technicians
Anesthesia Technicians keep anesthesia machines working properly, re-stock supplies, and maintain workspaces.
A medical doctor trained to administer anesthesia and manage patients medically before, during, and after surgery. ASA
Anesthesiologist assistants (AAs)
Always work under the direction of anesthesiologists to develop and implement anesthesia care plans (AAAA)
Anesthesiologist Board Certification
Certification by the American Board of Anesthesiology (ABA)
Ambulatory Surgery Center
Catchment area
The surrounding area served by a facility. This is usually larger that the actual city where the facility is located.
Certified Nurse-Midwives (CNM)
Certified nurse-midwives (CNMs)�are�Registered Nurses certified in midwifery. (ACNM)
Certified Professional Midwives (CPM)
Certified Professional Midwives (CPM)�are certified by�The North American Registry of Midwives (NARM).
Certified Registered Nurse Anesthetist (CRNA)
A Registered Nurse and advanced practice nurse that has acquired additional education and training to administer anesthesia. (AANA)
Claims-Made Malpractice Insurance Policy
Policy which covers claims which are reported during the policy period, meet the provisions specified by the policy, and are for an incident which occurred during the policy period. An earlier "retroactive" date may be specified in the policy to cover acts occurring prior to the original effective date.

The answer is conditional on something.

A non-medical assistant in prenatal care, childbirth and during the postpartum period.
Employee (IRS form W-2)
An "employee", will receive from his employer an Internal Revenue Service (IRS) form "W-2". Typically an employee will receive employee benefits such as medical insurance, retirement and paid time off. An employer will withhold Social Security, Medicare and income taxes. An employer will match Social Security and Medicare taxes.
Automatically renews as long as neither party objects.
Exclusive Contract
An exclusive contract means that only the contracted Anesthesia Group can work at the facility. Only anesthesia providers approved by the Anesthesia Group can work at the facility. Generally, in order for an Anesthesia Group to obtain an "exclusive" contract, it must agree to supply all of the anesthesia needs of a facility.
Candidate bills and collects individually for his services.� Typically, a billing service will be utilized.
First case of the day starts
Operating rooms that have cases to do first thing in the morning. Usually, this is at 7:30 AM and will require an anesthesia provider for that room.
Fixed guarantee
A fixed amount of money paid to an Anesthesia Group. That amount of money paid may have stipulations such as the number of "First Case of the Day", or number of anesthesia providers in the group. The Anesthesia Group would not necessarily need to disclose its financial details to the facility.
Gross Revenue
Gross Revenue is the amount of money that an Anesthesia Group collects minus all refunds. Refunds are payments made back to patients, Medicare, Medicaid, Insurance Companies and Managed Care. Gross Revenue minus expenses and taxes equals Net Income. A Gross Revenue guarantee would require that the Anesthesia Group disclose to the facility the amount of money collected.
Healthcare Facilities
Hospitals and other health care facilities such as Surgery Centers and Doctor's Offices.
Income as a Full Partner
Income as a partner is similar to, "percentage income". The difference is that as a, "full partner", you are entitled to an equal share of the overall group income. As a less than full partner, you may receive a percentage income that is less than that of a full partner.
Income from Hospital
Many hospitals will subsidize a candidate's income. A "yes" answer means that the hospital pays money to the candidate that is separate from his, "Fee-for-Service", income.
Independent Contractor (IRS form 1099)
Provides anesthesia services under contract and receives an Internal Revenue Service (IRS) form "1099". Typically will NOT receive other benefits, such as medical insurance, retirement and time off. An independent contractor must pay his own Social Security, Medicare and income taxes. He must pay estimated tax every quarter.
Anesthesia providers are legally separate from each other. Each provider does his own cases and bills separately.
Individual Practice: Fee-for-service
This is a situation where the candidate will have is own separate practice. His income will be derived from billing and collecting for his own services.
J-1 Visa Waiver Program
A program for International Medical Graduates to work in the Underserved areas.
Labor analgesia
Labor analgesia is labor epidurals or spinal narcotics ("Intrathecals") to provide pain relief to women in labor.
Maintenance of Certification in Anesthesiology (MOCA®)
American Board of Anesthesiology (ABA) re-certification program.
Medical Direction of CRNAs
Medical Direction of CRNAs means that an anesthesiologist "Medically Directs" Nurse Anesthetists or anesthesiologist assistants. Medical Direction of CRNAs is different from, "Medical Supervision of CRNAs".
Medical Direction of CRNAs/AAs
An anesthesiologist is in the medical direction mode when he is responsible for one to four CRNAs/AAs and meets Medicare's Seven Elements for Medical Direction.
Medical Supervision of CRNAs
When an anesthesiologist is medically directing more than four procedures concurrently or is performing services other than Medicare's six exceptions, the status of the case drops to a medically supervised mode.

It may also be used to bill for cases that start out as "medically directed" but in which the anesthesiologist becomes involved in other activities and is therefore unable to fulfill all seven requirements of medical direction.

The Medicare supervision modifier is AD.
Medically Directed AAs
Anesthesiologist Assistants (AA) must be Medically Directed. CRNAs may or may not be Medically Directed.
Medicare's Seven Elements for Medical Direction
  1. Perform a preanesthesia examination and evaluation;
  2. Prescribe the anesthesia plan;
  3. Personally participate in the most demanding procedures of the anesthesia plan;
  4. Ensure that all procedures are performed by a qualified anesthetists;
  5. Monitor the course of anesthesia at frequent intervals;
  6. Remain physically present and available for immediate diagnosis and treatment of emergencies;
  7. Provide indicated post-anesthesia care.
Medicare's Seven Elements of Medical Direction (Six exceptions)
There are six exceptions to the seven Elements of Medical Direction

The anesthesiologists may:
  1. Address an emergency of short duration in the immediate area;
  2. Administer an epidural or caudal anesthetic to ease labor pain;
  3. Periodically (rather than continuously) monitor an obstetrical patient;
  4. Receive patients entering the operating suite for the next surgery;
  5. Check or discharge patients in the recovery room;
  6. Facilitate and deal with scheduling matters.
Mirror Exclusivity
The anesthesia group given the exclusive contract can only work at that hospital and the hospital can only use that anesthesia group.
Mix of independent CRNAs and Anesthesiologists
Non-medically directed CRNAs working independently along side independent anesthesiologists. They may collaborate especially on difficult cases.
Net income guarantee
Net income guaranteed by a facility. Net income (Profit) equals Gross Revenue minus expenses and taxes. Expenses are business expenditures that are, "usual and customary" and qualify by the Internal Revenue Service (IRS) as deductible.
Nonmedically directed CRNA
The CRNA is NOT medically directed or supervised by an anesthesiologist.

The Medicare modifier is QZ.
Occurrence Policy
An "occurrence" policy covers claims arising from events occurring while the policy is in force, regardless of when the claim is first made.
Off site anesthesiologist Medical Director
An anesthesiologist may the "Medical Director" of an anesthesia group but not be physically at the facility where anesthesia services are performed. Although that anesthesiologist is a Medical Director, he would not be "medically directing" the CRNAs. The anesthesiologist may be corporate Medical Director who is available for consultation and policy decisions.
Payor means the entity that pays the anesthesia bill.
Payor mix
The percentage of cases that are Medicare, Medicaid, Commercial Insurance, HMO, Managed Care, and self-pay.
Pending Job
"Pending" Jobs are jobs that are not "Actual" jobs yet.
"Pending" Jobs are jobs that are contingent on something such as funding, contract signature, etc.
"Pending" Jobs may eventually become "Actual Jobs".
"Pending" Jobs provide useful information about a possible upcoming positions.
"Pending" Jobs, however, may never become "Actual" jobs due to a failure to secure funding or a signed contract.
Percentage Income
A percentage income is variable. The percentage income will depend on the total income of the anesthesia group. The total income of the group will depend on the number of cases and the payor mix of those cases.
Recertification in Anesthesiology
The American Board of Anesthesiology (ABA) is replacing its Recertification in Anesthesiology program with the Maintenance of Certification (MOCA™) program.
Request for Proposal (RFP)
A request from a healthcare facility to an anesthesia group to provide all of its anesthesia services.
Salary from Hospital as an employee
Salary from the hospital as an employee means that the hospital pays the candidate who receives an IRS form W-2.
Self-insured means that the facility is financially responsible for paying malpractice claims. Sometimes, the facility will cover the first dollar costs up to a certain amount such as 1 million dollars. Thus the facility will purchase coverage for amounts greater than 1 million. The concern for the anesthesia provider is whether or not the facility actually has the financial ability to pay a judgment against them.
Sign-on Bonus
Sign-on bonus is money paid to start work. It usually has a time commitment.
Stipend = "Compensation for Services" (CFS)�
Payment to�anesthesia group for a requested level of service NOT supported by the current revenue stream.
Surgical anesthesia
Surgical anesthesia is anesthesia that is provided for surgical patients, i.e. patients having surgical operations.
Thoracic Anesthesia

Anesthesia for surgery in the thoracic (chest) cavity.

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