Billing FAQs
I received two bills and both charges are the same, why?
Due to carriers’ rules, charges must be sent using the same codes with modifiers attached to indicate which provider supplied which service. The allowable amount is paid at 50% to each provider, thus the co-insurance will be the same. The payment is made to Northeastern Anesthesia Physicians, P.C. (NAP) and does not exceed what would have been paid if the claim were submitted for the Anesthesiologist alone.
Insurance Participation
Northeastern Anesthesia Physicians, PC participates with most insurance carriers; it is your responsibility to ensure coverage by checking with your Human Resources Department or insurance carrier.
Our billing department will submit a claim to your insurance carrier on your behalf; however, you are responsible for co-payments, co-insurances and deductibles. Reviewing your medical plan prior to your procedure will better prepare you for future billings.
The Billing Process
Your bill is due and payable when the service is rendered. In addition to cash, we accept personal checks, Visa, MasterCard, Discover and American Express. If you do not have insurance, we ask that you contact our office immediately at 610.628.8374. The sooner you contact us, the more options we will have if you will need to make payment arrangements.
We will submit your bill to the insurance company based upon the information we have on file before looking to you for payment. Since the business office personnel do not see patients before surgery, we rely upon the hospital or surgical facility to provide us with the appropriate information. Since many insurance companies have limitations on the time frame within which a claim may be filed, it is critical to ensure accurate information is provided at the outset to guarantee that your insurance company does not reject your claim for this reason, leaving you responsible.
We typically allow two billing cycles (sixty days) for the insurance company to pay. However, you may receive a bill stating your insurance carrier is requesting specific information, such as coordination of benefits or confirmation of college student status, etc. It is imperative that if you receive a bill stating your carrier requires specific information you must respond to your carrier as soon as possible. If your insurance has not paid after sixty days, we ask you to contact them and/or our billing office to determine how you may assist in expediting payment. After sixty days, we will look to you for payment of your outstanding bill. As such, anything you can do to expedite this process will serve everyone’s best interest. Outstanding balances that have reached ninety (90) days past due may be turned over to our collection agency if you have not contacted us and made prior arrangements for payment. Collection costs may be added as to the responsibility of the patient.
Financial Hardship
The Anesthesia Department is sympathetic to the financial burden placed on families who are coping with medical bills. We will consider an adjustment of your bill if certain criteria are met. Not all applicants are approved for an adjustment based upon their financial status. If a financial hardship exists, please contact us immediately so that we may review your financial information to determine if you qualify for a reduction of charges. If you are accepted for Reduced Cost care by the facility, you still must provide information to our office. There is no guarantee that you will be accepted for a reduction of your anesthesia charges. If necessary, our office will work with you to set up a payment plan that will assist you in meeting your financial obligation.
If you have any questions regarding your bill or your care please feel free to contact our billing office at 610.628.8374. Our billing department receives many calls and it is impossible to have someone available to answer calls all day. Please leave a message and someone will return your call. It is important for you to speak slowly, spell your name, and if available give your account number (nap…), reason for your call and a phone number you can be reached at during the day.
My Hospital Bill has Anesthesia Charges on it
The Hospital Bill has “Anesthesia Charges” for your Drugs and Supplies. Our Anesthesia Charges are for your Professional Services actually rendered from your Anesthesia Care Team.
My Deductible has been met – I don’t owe this
Your Insurance Company reduced your payment to us by your Deductible amount shown on your Explanation Of Benefits (EOB) Form. We don’t have control over that. We don’t collect these funds upfront, like some Facilities or Surgeon Offices do, we only bill for this if and when your insurance company deducts it from us. You will need to Contact your Insurance Company, or the Facility/Surgeon that you paid in advance. The funds are due to us, as we bill for all copays, co-insurances and deductibles up to the Allowable Amount by your Insurance Company. Please contact your Representative on the back of your Insurance Card for further explanation.
Overview
We typically work as an anesthesia care team. This means that, in addition to our Anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs) work in conjunction with our physicians to deliver your anesthesia care. They always work under the medical direction of our Anesthesiologists. In instances where both an anesthesiologist and CRNA are involved with your care, bills are submitted in accordance with federal guidelines. While this may appear to be a duplicate charge, as the codes used are the same, there are modifiers attached to each charge, which indicate to the insurance company how the service was provided.
Insurers have different ways of reimbursing in these situations and we work with their guidelines as indicated by their Explanation of Benefits (EOB) to determine the appropriate allocation of payments and patient responsibility.