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Billing & Insurance
Frequently Asked Questions about Anesthesia Billing and Insurance:
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 anesthesiologist’s 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.
Which health insurance plans have established "in-network provider" contracts with Group Anesthesia Services (GAS)?
This list is updated as of April 2010, and is subject to change at any time. For current information or any questions, please call GAS at (408) 354-2114.
Aetna
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) 354-2114What 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 online. Please go to AAI (our Billing Company) to learn more about paying your bill online.
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