Several changes in the health care climate have forced us to modify the way we bill for our services. In the past, we contracted with almost every managed care provider operating in the San Jose area. We accepted their discounted rates as payment in full for our services. Unfortunately, many of these payor have either failed to increase their rates or have even cut them back over the last several years. Some of our payors have been offering us rates lower than we received from them in 1992. It became financially unreasonable for us to continue with them. Secondly, the fact that there is a significant shortage of anesthesiologists in the United States, compounds the problem by making it extremely difficult to recruit to Silicon Valley, one of the most expensive areas in the country.

We have given counter offers to all of the payors that we previously contracted with in an effort to remain contracted with them. We have come to successful agreement with a few carriers noted on the Billing Information page. Unfortunately, with many of the other carriers not listed, we were not able to reach an agreement.

We will accept the contracted rates from the carriers listed. For those plans not listed, we will bill the patient for the balance of payment due. We regret that we have been forced to do this. We sincerely hope that we will be able to reach reasonable agreements with with insurance companies not listed such that balance billing of thee patients will no longer be necessary. We will strive to keep the Billing Information Page updated as new agreements are established.

After a surgery, our billing office will bill the patient's insurance, whether or not we have a contract with them. If the patient's insurance is not contracted with AAMG, the patient will receive a statement indicating that they are financially responsible for the portion of the bill not paid by the insurance company. The first statement may arrive prior to the insurance company paying our bill. The other anesthesia groups in our community bill their patients in a similar fashion.

We would encourage our patients to ask their insurance carriers to work with the local anesthesiologists to reach a reasonable agreement. Sometimes, if a call is made to insurance company explaining that there is no one in the area that takes the particular insurance, the carrier will pay the entire amount. We appreciate your patience and understanding.