Insurance & Billing

Understanding Your Insurance

Your physician’s office will provide us with your insurance and contact information prior to your arrival at our surgery center. An insurance specialist from our business office will verify with your insurance carrier and confirm that the appropriate authorization for surgery was received.

Depending on when we receive your insurance information, we will attempt to give you an estimate of charges or co-payment you are required to pay at registration. Cash, personal checks, and major credit cards will be accepted.

The Cost of Your Outpatient Procedure

Patients are responsible for payment of their procedure.

Although we accept most major health insurance plans, every insurance plan is different. You may have options for where you have your outpatient procedure. You can use tools like Healthcare Bluebook and the Medicare Procedure Price Lookup (for Medicare patients) to find out your financial responsibilities to have a procedure performed at our facility.  Many health insurance websites also provide information on where to find in-network services.

For an estimate of what your insurance will cover and what will be your responsibility, please contact your insurance carrier directly. If you do not have insurance or need payment arrangements, feel free to call us (415) 440-1100 for payment options.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia,
pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

You’re NEVER required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

California: Comprehensive Balance Billing Protections

  • State requires insurers to hold enrollees harmless for amounts beyond in-network level of cost sharing

  • States prohibits out-of-network providers from billing enrollees for any amount beyond innetwork level of cost sharing

  • Above protections apply:
    ● To HMO and PPO enrollees
    ● For (1) emergency services by out-of-network professionals and facilities and (2) non-emergency services provided by out-of-network professionals at in-network facilities
    ● Provided by all or most classes of health care professionals

  • State provides a payment standard

  • Protections do not apply to:
    ● ground ambulance services
    ● enrollees who consent to non-emergency out-of-network services
    ● enrollees in self-funded plans

When balance billing isn’t allowed, you also have these protections:

  • You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.

  • Generally, your health plan must:
    ● Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
    ● Cover emergency services by out-of-network providers.
    ● Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
    ● Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, contact the No Surprises Helpdesk at (800) 985-3059.

Visit for more information about your rights under federal law.
Visit for more information about your rights under California law

You Have the Right to Receive a “Good Faith Estimate”

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit or call (800) 985-3059.

How Billing for Anesthesia Works

Let’s begin with calling attention to the fact that Anesthesiologists and CRNAs are not always employed by the medical facility where a patient receives anesthesia care. A billing statement for anesthesia services may arrive separate from the our medical facility bill where a surgery or procedure takes place. The bill from an anesthesia provider is for the anesthesia services; developing the anesthesia plan, administering anesthesia and monitoring the patient’s vitals before, during and after a surgical procedure. It is possible to have a surgery or procedure at an in-network medical facility, but have an anesthesia provider that is not in-network with your insurance provider. Ask prior to any surgery or procedure if all your care providers are in-network.

Blue Eagle Anesthesia Group
(209) 956-7725

Patients that receive anesthesia care from Eye Surgery Center of San Francisco can expect to receive a billing statement in the mail for the anesthesia services received. The patient billing statement will reflect the payment options available. Those seeking financial assistance by means of a payment plan must contact Blue Eagle Anesthesia Group at the number provided on the patient billing statement to be put in touch with a billing specialist for other payment options.