Patient Billing

Patient Billing

ASPA will send you a bill for our professional anesthesia services, which will be separate from any hospital charges. As a courtesy, we will submit a claim to your insurance carrier on your behalf.

ASPA participates with the following insurance plans:

  • Aetna PPO
  • Independence Blue Cross
  • Highmark BCBS of Delaware
  • CIGNA
  • Coventry
  • Medicaid
  • Medicare
  • Tricare
  • United Healthcare

 

Pay A Bill

To pay a bill online, please sign in to our Quick Pay Portal.

 

Dual Charges

ASPA provides anesthesia services using the Anesthesia Care Team approach, which involves both an Anesthesiologist and a CRNA. Some insurance carriers require that we submit a claim for both providers, while other carriers require that we only submit a claim for the Anesthesiologist. If a claim is submitted for both providers, you may see both charges on the Explanation of Benefits (EOB) from your insurance carrier. In these situations, the payment made to ASPA never exceeds what would have been paid if the claim were submitted for the Anesthesiologist alone.

Usual and Customary Rate (UCR)

You may see a comment on your EOB stating that a portion of the total charge is not being allowed or considered for payment because it is above the Usual and Customary Rate (UCR). The UCR is usually determined by calculating the average charge for the procedure in question based on the geographic location of the hospital in which the procedure was performed. Theoretically speaking, this would seem to make sense. Practically speaking, however, the calculation falls short. The problem is that an insurance company typically obtains the UCR amounts from actuarial companies that have compiled all of the data based on a given timeframe. In other words, the data that is used is anywhere from six months to a year old at best. Physicians, like any other people in business (including insurance companies), need to adjust their rates to keep pace with the economy. Since most physician groups raise their rates on at least and annual basis, the data that is used to determine the UCR is almost certainly outdated. So not only does the patient have to pay an increase in monthly premiums but they are also held responsible for what is over and above the UCR amount allowed on their EOB. It is for this reason that we try to educate our patients and urge them to appeal to their insurance carrier for additional payment on their behalf.

Financial Hardship

For more information on our Financial Assistance program, or if you would like to view our Financial Hardship Guidelines or download a Financial Assistance Application, please click here.

If you have any questions regarding your bill, please feel free to contact us at 1-855-792-2772.

 

 

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