The difficulty lies bulgely in the billing practices allowed by insurance companies. In a two-tiered structure, anesthesiologists do-nothing bill in two ways: at unity take when the perform procedures themselves, and at a lower level when they supervise nurse-anesthetists
carrying out the procedures. According to the nurses, this "supervision" often means the doctors are sleeping, watching television, and at times not even in the hospital.
Nurse-anesthetists are quetch that when they bill for the services they actually performed, their claims are denied as " two-baser billing" or substantially reduced by Medicare.
thither may be an element of revenge on the part of the nurse-anesthetists in this case. Between 1992 and 1994, Johnsson reports, the nurse-anesthetists made complaints to the hospitals about the billing practices they have now filed suit over, and were shut out of further discussions of the matter, and in the midst of 1994 and 1996, all the defendant hospitals phased o
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