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 the insurance carrier's determination - called an Explanation of Benefits (EOB) - from your 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.
In the unlikely event that your insurance company mailed you a check for anesthesia services performed by Capital Anesthesia Partners, 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. Our billing office is open from 8AM to 7PM ET weekdays, excluding holidays.
Accounts that are not paid may be transferred to a third-party collections agency and/or reported to a credit bureau at our sole discretion. Once a balance is turned over to a collections agency, patients must work directly with that company. Our collections agency is Mid Atlantic Medical Collection Services, Inc and can be reached by telephone at 410-494-7932.
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:
Some insurance carriers have enacted "medical necessity" polices which may restrict a patient's coverage for endoscopic anesthesia. In cases where a carrier has a medical necessity policy, CAP will attempt to bill the patient's insurance. As health insurance coverage is a contract between the patient (member) and the carrier, CAP does not guarantee that its services will be covered, even if we have a contract with your specific carrier.
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, they may expect to pay $500 or more for anesthesia.
We know that health insurance and medical billing can be confusing. If you have questions regarding your specific plan coverage benefits (medical necessity policy), 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.
Accounts that are not paid on a timely basis may be transferred to a collections agency. If your account has been transferred to a collections agency, we are no longer able to assist you. Instead, you may contact Mid Atlantic Medical Collection Services Inc. at 410-494-7932.
For your convenience, Capital Anesthesia Partners participates with the majority of major health plans accepted at our practice locations. The list below 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 though anesthesia services for some EHP PPO members may be covered if their plan accesses the MultiPlan network.
NPI Number: 1265715692
For those patients who do not have current active health insurance or who do not wish to use their health insurance, Capital Anesthesia Partners offers a discounted self-pay price for anesthesia if payment is made in full on the date of the procedure. The cost of anesthesia services is $500 per encounter. This price is irrespective of whether a single procedure (e.g. a colonoscopy or an esophagogastroduodenoscopy (EGD)) or a double procedure (when a colonoscopy and EGD are performed at the same time) is performed. Read more.
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 you are scheduled for a "screening" colonoscopy, your insurance company will almost always pay the anesthesia fee in full. However, if there is a post-operative diagnosis other than "normal colon" (such as if polyps are detected), the patient is no longer eligible for a screening colonoscopy benefit under the ACA and a patient's unmet deductible, co-insurance or co-payment will apply. When a colonoscopy is performed due to a positive finding on a Cologuard® test, the colonoscopy is considered a diagnostic examination, not a screening, resulting in patient financial responsibility - irrespective of the findings of the colonoscopy. Additionally, once a patient has a screening colonoscopy that results in a post-operative diagnosis other than "normal colon" (such as if polyps are detected), the patient is no longer eligible for a screening colonoscopy benefit under the ACA for any future colonoscopy (irrespective of findings on subsequent procedures) and a patient's unmet deductible, co-insurance or co-payment will apply.
Several gastroenterology professional associations have long called for closing this loophole. Additionally, Capital Anesthesia Partners wrote letters to federal legislators and the Centers for Medicare & Medicaid Services advocating for this exact change as access to high-quality colon cancer screening through a colonoscopy - long considered the "gold standard" screening method - will help identify polyps and cancer earlier.
In 2020, The Removing Barriers to Colorectal Cancer Screening Act of 2020, which was included in the COVID Relief Bill, was passed by Congress and signed into law. The law closes a signifiant loophole in the Affordable Care Act. Previously, if polyps were discovered during a screening colonoscopy, the procedure changes from screening to diagnostic resulting in patient financial responsibility including deductibles, co-insurance and co-payments. These costs associated with a diagnostic colonoscopy acted as a deterrent to screening. The new law lowers this out-of-pocket cost sharing until it is completely phased out in 2030. Read more. You can also view a flowchart prepared by the AGA Institute for additional information.
Whenever 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 resulting in some patients having to pay either an unmet plan deductible, co-insurance and/or co-payment based on their health insurance company plan design.
Anesthesia is billed as a combination of ASA base units and time units. Unlike gastroenterologists procedures, anesthesia cannot bill separately for two procedures conducted at the same time. However, a patient's total out-of-pocket costs for these two procedures conducted at the same time are less expensive than if the procedures had been conducted on different days. While anesthesia for a screening colonoscopy is normally covered in full by an insurance carrier, patients would be responsible for the anesthesia bill for the EGD and a second facility charge fee (one for each date of service).
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.