Waiver of insurance billing

MLHANNA

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Some of the insurance companies no longer cover monitored anesthesia care (MAC) for Upper and Lower Endoscopy. They feel conscious sedation is sufficient, which is administered by the MD, not an anesthesiologist or CRNA. Our practice employs the anesthesiologists who provide the services for our endoscopies and therefore feel that, in order to provide a better service to the patients, they should administer the MAC and simply not bill the anesthesia portion of the service to the insurance company. In their opinion, if the ins co. isn't going to reimburse whether conscious sedation or MAC, we might as well provide the patient with the most comfort. As long as the services are well documented (of course), are we obligated to bill the patient's insurance? Since the service isn't considered medically necessary by the insurance co., if we billed, no cost-sharing would apply so I don't see why this should be an issue but can you confirm? :confused:
 

sherrm12

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MAC anesthesia billing

No, you don't have to bill the anesthesia charge to the insurance company. We find that we can get paid for anesthesia if the patient has other conditions that warrant the use of anesthesia (i.e. sleep apnea) But, if the patient's insurance does not cover, and you want to provide to the patient at no cost, it's perfectly okay to do so.
 
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