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Billing & Insurance


 

Billing & Insurance

Frequently Asked Questions about Anesthesia Billing and Insurance:

How am I billed for anesthesia?

How does health insurance cover charges for anesthesia?

Which health insurance plans have established "in-network provider" contracts with Group Anesthesia Services (GAS)?

What can I do if my plan is not contracted with GAS?

What other methods of payment are offered?

How am I billed for anesthesia?
Professional services for anesthesia include patient evaluation, assessment and planning for the anesthetic, in addition to care before, during, and after your procedure. Charges are calculated by multiplying work units by the usual, customary, and reasonable (UCR) rate. Work units are based upon the type of procedure (e.g., hernia repair vs. cardiac bypass), duration of direct care, and any special monitoring and/or therapeutic techniques (e.g., postoperative epidural pain relief). The UCR is determined by the provider, based upon local expenses, historical rates, and market factors.
Charges for anesthesia medications and supplies may appear on an itemized bill from your facility, and are separate from the anesthesiologistís professional charges.
How does health insurance cover charges for anesthesia?
Terms of coverage vary among plans; please consult your policy for details. For procedures covered by insurance, the health plan generally pays a portion of the anesthesia charges and the subscriber pays the balance, provided the plan's deductible amount has been met. For plans that have established contracts with GAS (i.e., GAS is an "in-network" provider), charges are discounted according to the terms of the contract. Unfortunately, however, a few PPO plans have not established contracts with GAS (and therefore GAS is an "out-of-network" provider). These plans still typically pay a portion of the either the total charge or the plan's limiting charge (which is sometimes paid directly to the subscriber), with the subscriber ultimately responsible for paying the charges to GAS.
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Which health insurance plans have established "in-network provider" contracts with Group Anesthesia Services (GAS)?
This list is up to date as of September, 2013 and is subject to change at any time. For current information or any questions, please call Group Anesthesia Services at (408) 354-2114.

Aetna

Affinity

Anthem (Blue Cross)

Bay Valley Medical Group

Beech Street ****

Blue Cross (Anthem)

Blue Shield

Camino Medical Group

Concentra Preferred Systems

Coventry

First Health / CCN

Galaxy Health Network

GEHA (Gov't Employees)

Great West

Medi-Cal

Medicare

MultiPlan (ADMAR/BCE Emergis and some Health Net, Cigna, Principal Financial Plans billed through MultiPlan) ***

Northern Cal Advantage Medical Group, Inc.

PacifiCare

Palo Alto Medical Foundation

Physicians Foundation for Medical Care

Physicians Medical Group of San Jose

Physicians Medical Group of Santa Cruz

Preferred Medical Claim Solutions

San Jose Cardiac Surgery Group

San Jose Medical Group

SCCIPA (Santa Clara County IPA)

Tricare / Champus

United Administrative Services

United Healthcare

Workers Compensation

*** Note: many insurers such as Cigna, HealthNet, and others are covered under Multiplan. Check your insurance card/insurer or call the GAS office (408) 354-2114.

**** Note: many insurers such as Cigna, HealthNet, and others are covered under Beech Street. Check your insurance card/insurer or call the GAS office (408) 354-2114

What can I do if my plan is not contracted with GAS?
GAS is committed to assisting you with any financial issues you may have. We strongly encourage you to call our office (408) 354-2114 before or after your procedure to confirm your plan's contract status with GAS and to receive an estimate of charges.
If your plan does not have a contract with GAS, you should contact your plan to get an estimate of their expected financial contribution. Some non-contracted plans will still pay a significant portion of charges, especially if there are no contracted providers available in the area.
If you feel your plan leaves you with an unreasonable financial burden GAS offers payment plans or financial hardship discounts on a case-by-case basis. Please ask about our Bridging Program for insurance plans we are currently in contract negotiations with.
What other methods of payment are offered?
In addition to traditional methods of bill payment, you may also pay your bill directly, including online. Please go to ABC (our Billing Company) to learn more about paying your bill via these methods or you may call their patient direct phone number at 800-275-2152. Any direct payments should be mailed to: Group Anesthesia Services, Dept LA 24113, Pasadena, CA 91185-4113.
 

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Telephone: 408-354-2114 • Fax: 408-354-0633 • Email: info@groupanesthesia.com
718 University Avenue, Suite 211 Los Gatos, CA 95032