Stat Anesthesia Specialists< Ltd

Stat Anesthesia Specialists, Ltd. accepts assignment from most insurance companies. Stat’s Patient Accounts staff will obtain pre-authorization, verify benefits and bill medical insurance directly for those patients with medical health insurance coverage. (Please note that the fees for anesthesia services are separate from those of the doctor or the facility.) The estimated payment for services after your insurance makes payment may be collected on the date of service. PLEASE UNDERSTAND that we bill medical insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of anesthesia services.

For those patients without medical health insurance coverage, or if the anesthesia is for a procedure that is not a covered service as determined by your medical insurance policy, payment is due on or before the date of service. We accept personal checks, money orders, cashier’s checks, Mastercard, Visa, American Express and Discover. Alternatively, financing with no interest for up to 18 months may be available through Care Credit www.carecredit.com and Surgery Loans www.surgeryloans.com. (Please note both Care Credit and Surgery Loans are independent financing companies and certain terms and conditions apply).

Patients Scheduled for Dental Services
Anesthesia services are a considered a medical service, and therefore are not covered by Dental Insurance plans, which provide benefits for dental services only. Anesthesia services for dental procedures are covered by medical insurance under limited circumstances such as traumatic injury (such as an accidental injury), fully or partial bony impacted wisdom teeth extraction, in some pediatric cases, and other special circumstances.

We are Here to Help:

While our staff works diligently to obtain all insurance pre-authorization, pre-certification and benefit verification, we highly recommend that patients refer to their individual insurance policy or contact their insurance company directly for their anesthesia benefit information such as annual deductible, co-payments, and other out-of-pocket expenses, limitations or restrictions contained in of their policy. Should assistance be required in obtaining insurance benefit information, please feel free to contact the Patient Account staff Department at 866-429-6035.

Top Three Misunderstood Facts Regarding Health Insurance:

MY INSURANCE PAYS 100% OF MY MEDICAL BILLS:
Health insurance is meant to be an aid in receiving medical care. Many patients think that their insurance pays 90%-100% of all medical services. This is typically not true! Most plans only pay between 50%-80% of the average total bill. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company. There are literally thousands of contracts available for employers to choose from.

BENEFITS ARE NOT DETERMINED BY OUR OFFICE:
Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a fee they call the "allowable" UCR Fee. Frequently this data can be three to five years old and these "allowable" fees are fees that are set by the insurance company so they can make a net 20%-30% profit. You may have noticed that sometimes your insurer reimburses you or your practitioner at a lower rate than the practitioner’s actual fee. Frequently, insurance companies state that the reimbursement was reduced because your practitioner’s fee has “exceeded the usual, reasonable and customary fee (URC)” that is established and used by the insurance company”.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company (URC) is unreasonable or well above what most practitioners in the area charge for a certain service. This can be very misleading and simply is not accurate. Unfortunately, insurance companies imply that your practitioner is "overcharging" rather than say that they are "underpaying" or that their benefits are low.

DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED:
When estimating benefits, deductibles and percentages must be considered. For illustrative purposes only, let’s assume Mary Jones has ABC Insurance. Mary sees her practitioner and the fee for the service is $1,000. Assuming ABC Insurance Company allows the entire fee of $1,000 as its usual and customary (UCR) fee, we can then determine what Mary will have to pay. First Mary has to pay her deductible - which in Mary’s case her calendar year deductible is $1,500 and at the time Mary saw her practitioner, Mary has only paid $1,200. ABC Insurance Company then subtracts Mary’s remaining deductible from the allowed fees, or $300, leaving $700.00. ABC Insurance Company then pays 80% of $700, which is $560. This leaves a balance of $440 to be paid directly by Mary. Of course, if the UCR is less than $1000, or Mary’s plan had a higher deductible or paid at a lower percentage, then Mary’s insurance benefits will be significantly less, leaving more for Mary to pay directly out of her pocket to the practitioner.