2012 Conversion Factor Survey

1. Introduction - IMPORTANT - PLEASE READ

 
 6% 
The American Society of Anesthesiologists invites you to participate in our tenth survey of commercial payment rates. As with previous surveys, we will publish the results in the ASA NEWSLETTER later this year. We would greatly appreciate your help with this update. As a reminder, the Statements of Antitrust Enforcement Policy in Health issued jointly by the Department of Justice and the Federal Trade Administration make it possible for us to gather this information as long as certain conditions are met. The most important condition, besides only publishing aggregate statistics, is that the data you provide be AT LEAST THREE MONTHS OLD.

Please provide the following information for your five (5) highest-volume commercial payers (not Medicare, Medicaid, other government payers) based on volume of services provided on an annual basis. If you have fewer than five contracted commercial payers, please enter information for all of your commercial payers. AGAIN, PLEASE ENSURE YOUR DATA IS AT LEAST THREE MONTHS OLD.

TO OUR ANESTHESIOLOGISTS: Please ask your practice manager or billing service to complete this questionnaire. It is important that we receive only one response from each anesthesia group. We ask that you or your staff complete the survey NO LATER THAN JULY 13, 2012.

If you have any questions, please do not hesitate to contact Loveleen Singh, ASA's Health Policy Analyst (L.singh@asawash.org).

Thank you for your participation!
Powered by SurveyMonkey
Check out our sample surveys and create your own now!