Billing Information

BILLING INFORMATION:

As most patients are acutely aware, the business of healthcare can be very costly and sometimes stressful to think about. We would like any time you spend with us to be as stress free as possible.

Because we are aware that communication is so important when it comes to health care and understanding the costs associated with it, we have provided you with this informational brochure to share with you, in advance, the nature of how you might receive information and possibly bills regarding the Anesthesia services provided by Pinnacle.

Although Pinnacle serves as the exclusive Anesthesia provider for the hospital facility, it is important to us that our patients understand that Pinnacle is a separate "business entity" from the hospital you are receiving your care at.

Prior to receiving care at a hospital, patients (or their surrogates) sign numerous forms and documents. One of these forms is an acknowledgment that some of the services provided by some hospital based providers (Anesthesia providers included) will be billed to you or your insurance carrier separately from the hospital charges, and it includes an agreement on your part to be responsible for these "non-hospital charges" if indeed you are subject to being billed for them.
Whether or not you will receive a bill from Pinnacle depends on many factors, including whether you are covered by health insurance or not; who is your primary (and any secondary) insurance carrier; your copayment and deductible structure under any plan you may be covered under and also upon the type of benefits your particular plan provides whether in or out of network. Additionally, Pinnacle may or may not be "participating" with your health insurance carrier; for any number of business related reasons. Although it is our goal to achieve mutual agreement on "participating" with as many carriers as possible for any given year, it is not always possible for this to occur. Therefore, this factor might also affect whether or not you receive a bill for our services.

If Pinnacle is a "participating provider" with your health insurance carrier then you should not receive any additional bills from us, other than bills for copayments and or deductibles that are a part of your plan, and by law, your own responsibility to satisfy with us under the terms of your plan.

If you receive health benefits from an "HMO Plan," then you should not receive any additional bills from Pinnacle Anesthesia, again with the exception of required co-payments and or deductibles. There are however exceptions to this with respect to HMO patients whose surgical, endoscopic or obstetric procedures, for which Anesthesia is provided, are not included in the coverage terms of their health care plans or when they are procedures which are specifically excluded from coverage for one reason or another.

There are also instances when some out of network plans do cover our full charges and in such cases you would not receive a bill from us above any routine copayments and or deductibles which would be your responsibility.

If Pinnacle is not a participating provider with your insurance carrier and you are not in an HMO Plan with your insurance company, depending upon your plan type and the out of network coverage which you are entitled to under your plan, you may receive a bill for the remaining balance on the Anesthesia charges which your health plan does not pay for. This bill will come from us, and not your insurance company, and will be different from your co-payments and/or deductibles, which you are responsible for. We hope you understand that some plans do not cover everything.  Unfortunately, we do not receive information about your out of network benefits in advance of your procedure, and it has been our experience that most patients do not have this information in advance either.

If you receive an Explanation of Benefits form (EOB) and would like more information you are welcome to contact us, but please be aware that EOB forms are frequently received well in advance of when we receive the same information so we may not be able to assist you immediately. 

INFORMATION FOR PATIENTS NOT CURRENTLY COVERED UNDER ANY HEALTH INSURANCE PLAN

If you do not have any type of health insurance at the time you require Anesthesia (and were not a trauma victim residing in Palm Beach County), then the bill for your anesthesia services will be your own responsibility to satisfy with us.

For electively scheduled procedures, upon preregistration at the hospital, you will be notified of our current fee schedule and you will be required to pay for the Anesthesia for your procedure in advance. Patients who choose to pay in advance by check must do so at least ten business days in advance of their scheduled procedure. If you contact us, either via telephone or via our website, we can send you our fee information in advance.

BILLING QUESTIONS, CONCERNS AND CONTACT INFORMATION
If you receive a bill from Pinnacle Anesthesia, and if it presents an economic hardship, we have very reasonable processes in place for which to seek us out, communicate and even address hardship cases with special arrangements such as payment plans or courtesy discounts.

As a first step in addressing any questions you might have about a bill which you have received or might receive from us in the future, please feel free to contact our Patient Account Specialist during regular weekday business hours by telephone (561)495-3535, or feel free to email us twenty-four hours a day/7 days a week at the following email address:  billinginquiries@pinnacleanesthesia.com