Advocacy in Action | Anesthesia Bill Assistance

A member contacted The Purple Card® because she received an anesthesia bill showing she was being balanced billed for $900. The member sent a copy of the bill to her Patient Advocate because she wanted to understand why the provider was sending her a bill. The procedure had been pre-authorized and the facility she used was an in-network facility. The Patient Advocate checked and found out the anesthesiologist was not an in-network provider and because he was not contracted with the carrier he had a right to balance bill the patient. The Patient Advocate filed an appeal with the insurance carrier stating the procedure was pre-authorized and the member used an in-network facility. The insurance carrier reviewed the matter and agreed to pay the out-of-network balance billed amount to the service provider. Once the additional payment was processed and sent to the provider, the member had no patient responsibility and owed the provider nothing. Here is what the member had to say about the services received from The Purple Card®:

“Oh my gosh you are wonderful!!! THANK YOU, THANK YOU, THANK YOU for your prompt response and saving the day!!!”