Once your insurance company has processed our anesthesia claim (usually 30-45 days after your procedure), we will send you an account statement that details our charges, any payments made by your insurance carrier and their determination of any out-of-pocket costs (co-payment, co-insurance and/or deductible) for which you are financially responsible. You may also obtain a copy of your Explanation of Benefits (EOB) from your insurance carrier.
We offer several convenient ways by which you can pay your invoice:
Capital Anesthesia Partners
PO Box 17665
Baltimore, MD 21297
Payment is due, in full, immediately upon receipt of our invoice. Our ability to continue providing medical services diminishes if we are unable to collect, in full, for our services in a timely basis. Accounts that are not paid may be transferred to a third-party collections agency at our discretion.
In the unlikely event that your insurance company mailed you a check for anesthesia services, you may either endorse the check and mail it to us or send us a personal check for the amount paid to you.
Should you have any questions about your account statement, please call our billing office at 1-800-222-1442.
We participate (are in-network) with every* insurance carrier that is accepted at the facilities at which we provide care. This means that we have negotiated a contracted rate with your carrier to provide our professional services. Your carrier will determine if you have any financial responsibility (co-payment, co-insurance or deductible) based on the specific plan and benefits you chose at enrollment.
Patients may expect to receive as many as four bills for their outpatient procedure:
Capital Anesthesia Partners believes that patients should be able to anticipate costs related to receiving medical care. Our patients' average out-of-pocket cost for anesthesia services is $85 (average deductible is $287). If a patient has a high-deductible plan where the deductible for the plan year has not yet been met, he/she may expect to pay $500 or more for anesthesia.
We know that health insurance and medical billing can be confusing. To that end, we have created the attached Understanding Your Anesthesia Bill brochure. If you have questions regarding your specific plan coverage benefits, co-payment, co-insurance or deductible, please contact your insurance carrier or your employer's human resources department. Should you have any questions about our charges or your account balance, please call our billing office at 1-800-222-1442.
Kaiser Permanente Members
* Despite our multiple attempts to pursue an in-network contract with Kaiser Permanente, they notified us most recently on January 21, 2020 that they "will not be pursuing a contract with [our] practice." Therefore, many of Kaiser's plans will process as out-of-network claims despite CAP's best efforts to reach a negotiated agreement with your insurance carrier. CAP's out-of-network rates will apply for services. If you have any questions or concerns about Kaiser's decision, please contact the member services telephone number on the back of your insurance card.
Johns Hopkins Healthcare Members
* Capital Anesthesia Partners has made several good-faith efforts (in 2017 and most recently in 2020) to negotiate a fair, in-network contract with JHHC. However, JHHC required CAP to accept an initial contract rate well below market rate for other commercial carriers with whom we are contracted. Some members (for example patients with JHHC's EHP product) may be able to access CAP's services using our MultiPlan contract. Otherwise, CAP's out-of-network rates will apply. Should you have any questions or concerns about JHHC's decision, please contact the member services telephone number on the back of your insurance card.
For your convenience, Capital Anesthesia Partners participates with the majority of major health plans, listed below. This list is provided as a courtesy and is subject to change at any time. If your insurance carrier is not listed, you may still be covered through a partner carrier. Please contact our billing office at 1-800-222-1442 for questions about eligibility.
* We are NOT contracted with Johns Hopkins Medical Plan or Kaiser Permanente though anesthesia services for some members may be covered based on their individual plan design.
NPI Number: 1265715692
The Affordable Care Act (ACA) has allowed for several preventative services, such as colonoscopies, to be covered at no cost to the patient. However, there are federal legislation limitations that may prevent patients from taking advantage of this provision, thereby resulting in out-of-pocket costs.
If you are age 50 years or older (45 years old or greater for African Americans due to an increased risk of colorectal cancer) AND have no personal history of gastrointestinal disease, colon polyps and/or colon cancer AND if no abnormal results are identified in your "screening" colonoscopy, your insurance company will almost always pay the anesthesia fee in full.
In any other circumstances, including where a colonoscopy begins as a "screening" but results in a post-operative diagnosis of polyps, hemorrhoids, diverticulitis, etc., the screening benefit no longer applies and you will be responsible for any out-of-pocket costs associated with the anesthesia professional fee. Further, once there is a post-operative diagnosis other than "normal colon," the patient is no longer eligible for a screening colonoscopy benefit under the ACA.
If another procedure (e.g. Upper Endoscopy) is performed at the same time as a colonoscopy, the ACA's screening benefit does not apply to anesthesia charges.
A bi-partisan group of US Senators sent a letter to CMS Administrator Verma to fix the colonoscopy screening loophole administratively. This action would prevent patients from any financial responsibility if a polyp is found during a procedure. CMS has not taken any action to date. Read the full letter here.
The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered, a substitute for professional medical advice. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider, dial 911 or report to a medical facility.