We are honored that you have chosen our practice to care for your child. We realize that this is a very stressful time for you and your family, and fear of unexpected expenses may contribute to further stress. We have assembled the following pamphlet to inform you of possible charges related to your child’s upcoming operation. These charges stem from several sources including the surgeon, hospital, anesthesiologist, and others. Each of these is described below.
Our office will work on your behalf to ensure that your child’s surgery is precertified with your insurance company. Insurance companies will never guarantee benefits until a claim has been submitted. We strongly recommend that you carefully review your specific insurance benefits to avoid unexpected bills after your child’s surgery.
For non-urgent procedures, if our office is unable to obtain an authorization from your insurance company by the day before the surgery we will postpone the surgery until the necessary authorization is obtained. If you have any questions regarding precertification of your child’s surgery please contact our surgery scheduler at 303-839-6001.
If your child’s surgery is not a covered benefit according to your insurance company, you will be considered “self-pay.” This means that your insurance will not pay for the procedure. Our office will work with you regarding the surgeon’s fee, but the charges must be paid in full be fore your child’s surgery date.
Our surgeon will submit charges for each procedure performed during your child’s surgery. For instance, if a boy has bilateral (both sides) hernias, there will be two procedures performed and billed.
Any charges that are applied toward your deductible or out-of-pocket expenses are your responsibility to pay.
Please contact our billing office at 303-584-8060 for any questions regarding our billing procedures.
Your insurance plan may dictate which facility or type of facility should be used for surgery. You will be billed by that facility independently. The facility fee is dependent upon the type of surgery performed and the length of the procedure. These charges may include recovery room care, use of monitoring equipment, medications given, and other supplies used. Review your policy to see what is covered, or contact your insurance representative for more information.
Please feel free to contact he specific facility with any financial questions or concerns:
- P/SL Medical Center-303-839-6000
(ask for Patient Finance)
- Sky Ridge Medical Center-720-225-1500
(ask for Patient Finance)
- Sky Ridge Surgical Center-720-225-5000
If you need your child’s specific surgical procedure code to help facilitate your call to the hospital, please feel free to contact our office at 303-839-6001 and will be glad to assist you.
The Anesthesiologists will bill for their services based upon the type of surgery your child is having, the amount of time involved with the case, and the child’s overall medical condition. Depending on your insurance plan, you may be billed for co-payments, co-insurance, deductibles, or remaining balances.
Our office uses two pediatric anesthesia groups. Please feel free to contact the appropriate group for questions regarding their individual billing procedures. If you are unsure of which group your child’s surgery is scheduled with, please contact our office at 303-839-6001.
Pediatric Anesthesia Consultants - 303-869-2035
Surgical Assistant Charges
The complexity of your child’s procedure may require the use of a pediatric surgical assistant to complete the procedure in a safe way.
Surgical assistants are not provided by the facilities, and surgical assistants bill separately for their services. Most insurance companies do not cover the cost of a surgical assistant. Many insurance companies consider a surgical assistant as an “out of network” benefit, and apply their charges to your deductible. Insurance companies will never guarantee an assistant fee as a covered benefit.
Depending on the surgery, you may see separate charges from the pathology department.
You may see separate charges for any radiology procedures that were required during your child’s surgery or hospital stay.