ABN ​for commercial or private pay use (updated 7/16/25)

Anatomical chart - abdomen & hernia information (updated 9/7/20)

Anesthesia estimate calculator  (This can be updated to use as a good faith estimate - make sure you take all anesthesia charges into consideration, including potential ancillary services such as post op pain, arterial lines, etc.)

AR (Accounts Receivable) Key Performance Indicators (KPI's), Physicians Practice, Inc. 2001 (not specific to anesthesia)

ARNP protocol, State of Florida

ARNP protocol (non-medically directed), State of Florida 

ARNP Protocol (changed 6/23/17 - updated 9/16/21) Link to changes below. Florida still requires protocol are maintained, although they no longer are filed with the Board of Nursing.  Leaving the above protocol examples on my website!
https://floridasnursing.gov/forms/arnp-protocol-format.pdf 

Audit template shared (for internal audits - edit to fit your practice needs)

​Billing company list  (Last Updated 1/28/26) 
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​Billing company questions (Last Updated 2/13/24)

Billing Company Evaluation - R. Smith (includes questions - updated in 11/5/25)

Collections Report (Sample report to track KPI's)

Column B procedures (Florida example)

Coding accuracy (template - edit to fix your practice needs)

Continuing Education Tracker (edit to fit your needs) 

CVP Form (last updated 2009)

Denial tracking

Difficult intubation (dr. letter)

Difficult intubation (patient letter)

E & M worksheet (Firstcoast, Florida Medicare)

Internal audit form (simple)

Julie's Colonoscopy Coding Decision Tree 
julies_colonoscopy_decision_tree.docx

Medi-Cal Calculations from YouTube video
youtube_medi-cal_example_062324.xlsx

Monitored anesthesia care (MAC) worksheet example (updated 9/14/22)
mac_worksheet_2022.docx
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Office of Inspector General (OIG) Compliance plan elements

See updated codes in 2025 for PECS, or ask an anesthesia friend!
PEC I Example Procedure Notes (Shared by Twin Oaks Anesthesia - Thank you!) pecs_1_block_procedure_form.pdf

PEC II Example Procedure Notes (Shared by Twin Oaks Anesthesia)
pecs_2_block_procedure_form.pdf

Sample Usual Customary and Reasonable (UCR) Letter

When an employee leaves (example)

When an employee starts (example)

  Thank you for sharing.  If you have a fantastic form to share, let me know! 
​Credit is always given to the author(s).