Patient Billing & Fees
Prior to scheduling your anesthesia appointment with our Anesthesiologist, our Patient Forms & the Financial Agreement must be completed in their entirety, signed, initialed, accompanied by the deposit, and returned to our office by fax or email.
- We require a Minimum Non-Refundable Deposit of $500 for children and $750 for adults prior to scheduling your procedure.
- The non-refundable deposit covers the cost of medications, equipment, setup and breakdown of the anesthesia treatment room, travel and administrative costs. At the end of the surgery, the deposit will be applied to the total amount due for anesthesia services.
[Note: In order for us to ensure our patients safety. Failure to comply with any pre-operative instructions and/or all Eating and Drinking instructions will result in the cancellation of the surgery/anesthesia and the forfeiture of your deposit].
- PAYMENT FOR ANESTHESIA SERVICES IS DUE IN FULL ON THE DAY OF SERVICE.
- Anesthesia is billed in 15 minute increments. The Patient/Parent/Legal Guardian is only responsible for actual total anesthesia time.
- If the procedure is less than the estimated amount, the Patient/Parent/Guardian will be billed accordingly. If the estimated time is longer, the Patient/Parent/Guardian will be billed for the additional time based on the actual anesthesia time.
- We accept Credit Cards (MasterCard, Visa, American Express, Discover, CareCredit), Money Order and/or Cash.
- WE DO NOT ACCEPT CHECKS.
TOTAL ANESTHESIA COSTS is based on 15 minute increments of time (units) and is determined as follows:
- SURGEONS TREATMENT TIME + 1 – 1.5 hrs of ANESTHESIOLOGISTS TIME which consists of a physical exam, administration of a preoperative sedative (if required), placement of monitors & IV, anesthesia induction, maintenance and the administration of medications throughout the surgical procedure and the entire recovery process.