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North Houston Anesthesiologists,
P.A.
808 Russell Palmer Road, Suite 151
Kingwood, TX 77339
Telephone - (281) 540-7500
Fax - (281) 540-7502
North Houston Anesthesiologists accepts patients with any insurance
medical coverage.
As of February 2007, the group is currently contracted with the
following commercial payors:
- Aetna
- Blue Cross Blue Shield and HMO Blue
- Cigna
- HAS
- Humana
- Kelsey-Seybold
- Methodistcare
- ppoNext
- Unicare
Feel free to verify with our billing office
before services our provided for the most updated coverage.
We bill claims to non-contracted payors. Some of them, primarily
United, will pay for hospital-based physician services as in-network
when both the hospital and surgeon are both in-network.
You should check with your insurer to see
what coverage your policy provides to out-of-network hospital-based
physicians. write "wrap-around" clauses into many (but not all)
of their benefit policies.
You should review your policy's coverage
to determine how they treat out-of network Wrap-around clauses apply
when the hospital/facility and surgeon are both in-network with
the payor.
The clause lets the payor pay ALL provider
claims for the surgery as if they were in-network, even if they
are not. Payors with wrap-around clauses recognize that patients
only get to choose their hospital/facility and surgeon, and have
no say in who provides the other hospital-based services, such as
anesthesia, radiology, pathology/lab, etc., and therefore do not
penalize the patient by applying the lower out-of-network benefits.
However, if either the surgeon or hospital/facility are out-of-network,
then the wrap-around clause is not applicable and any out-of-network
claims are paid using out-of-network deductibles and benefit levels.
Even if the facility advises the patient
that they will only charge their in-network deductible and co-pay
amounts, the payor will still not apply wrap-around if the hospital/facility
are not contracted with the payor. In this situation, the patient
will unfortunately falsely believe they will not suffer ANY out-of-network
penalties.
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