INSURANCE & BILLING

 

Your anesthesiologist is not employed by any hospital or outpatient surgery center. You will receive a separate bill from TAMGI for our professional services. The itemized bill from the hospital/surgery center may include "anesthesia" charges, but these cover medications, equipment, and other supplies, not the care provided by your anesthesiologist.

Our anesthesia fees are based on the Relative Value Guide developed by the American Society of Anesthesiologists, and are recognized by Medicare, Medicaid, and major insurance companies. The Relative Value Guide incorporates three types of “units” into the final fees:

The total unit value for your procedure is calculated and multiplied by our per unit fee, which is based on community standards. For your convenience, this amount will be billed directly to your insurer.

In-Network Patients

TAMGI is contracted (in-network) with Medicare, Medicaid, and many major insurers. If we are contracted with your insurer, we will bill your insurer directly based on the calculated number of units. Your insurer will pay TAMGI at the contracted unit rate, minus any applicable co-pays/deductibles. You will receive a bill from Medac (our billing service) for these co-pays/deductibles. The list of in-network plans varies, but this should not influence your individual bill (see below).

Out-of-Network Patients

Despite attempts on our part to negotiate in good faith, some insurers refuse to pay TAMGI the average per-unit rate paid to physicians in California and other western states. If we were to accept these lower rates, we would be unable to retain our highly qualified staff and our patients' care would suffer. However, this does not influence how much you pay out of pocket. If we are out-of-network with your insurer, we will bill your insurer directly based on the calculated number of units. TAMGI will then analyze your individual health insurance plan. As a courtesy to our out-of-network patients, our intention is to bill you at the discounted in-network rate for any co-pays / deductibles, whether or not we are contracted with your current insurer.

In either case, co-pays/deductibles may be paid by check or by credit card (either online or by phone). To make payments or for any billing questions, please contact Medac at (866) 483-3814 or at www.medac.com.

Please note: Some insurance companies not currently contracted with TAMGI may send full or partial payments for rendered anesthesia services directly to patients. Our billing service closely tracks these direct-to-patient payments. If you receive a check from an insurer for anesthesia reimbursement, you will also receive a letter from us explaining exactly what to do to settle your bill. If you do not receive a letter, please contact Medac at (866) 483-3814 or at www.medac.com.

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