Piedmont Triad Anesthesia offers several convenient ways for patients to make payments, including in person, by phone, by mail or on this website.

For more information, please visit Billing Center on this website.

You will receive a separate bill for anesthesia services rendered by PTA physicians. PTA participates with the following payers and plans:

• Aetna
• BCBS of NC (including out-of-state plans)
• Blue Medicare (BCBS)
• CIGNA
• Humana Military (Tricare)
• MedCost
• Medicare
• Medicare Advantage Plans (All)
• Medicaid – NC
• Medicaid Managed Care Plans (All)
• Medicare – Railroad
• Medicaid – VA
• United Healthcare

Please note:​ If your plan is not listed, you have certain protections against surprise medical bills under the federal “No Surprises Act.” In accordance with the law, you may receive from our office a bill reflecting the owed balance of your cost-sharing obligation (e.g., your deductible) for the relevant service.

For more information, visit www.cms.gov/nosurprises/consumers

Piedmont Triad Anesthesia’s billing policy will help you understand how accounts are handled and what your responsibilities are as a patient. We also understand that healthcare billing can be confusing and that healthcare expenses may cause financial difficulty for some patients. Please remember that patients are responsible for the charges for services received. Any unpaid balances, including co-insurance, co-pays, deductibles and noncovered services are the patient’s responsibility and must be paid within the time period outlined on our statements. We hope this policy clarifies some of the issues.

As a patient you are responsible for: 

• Providing accurate, honest and complete information regarding billing and insurance.
• Contacting your insurance company prior to receiving services when precertification or prior authorization is required by your insurance plan.
• Contacting your insurance company when notification of outpatient or inpatient services is required by your insurance plan.
• Paying deductibles, co-insurance and co-pays when applicable.
• Assisting our office in collecting from the insurance carrier by providing all requested information and calling your insurance company if the claim remains unpaid after 45 days. Should they delay payment beyond 45 days, you may be billed and you may be expected to pay the charges.
• Paying your account promptly or contacting our office if payment is a concern.

Making sure the bill for services rendered is paid promptly regardless of any pending litigation resulting from an injury caused by a third party.

This Statement of Privacy applies to the Piedmont Triad Anesthesia website and governs data collection and usage. By using the Piedmont Triad Anesthesia web site, you consent to the data practices described in this statement.

Piedmont Triad Anesthesia is committed to protecting your privacy and developing technology that gives you the most powerful and safe online experience. This Statement of Privacy applies to the Piedmont Triad Anesthesia website and governs data collection and usage. By using the Piedmont Triad Anesthesia website, you consent to the data practices described in this statement.

Collection of Your Personal Information
Piedmont Triad Anesthesia collects personally identifiable information, such as your email address, name, home or work address and telephone number. Piedmont Triad Anesthesia also collects anonymous demographic information, which is not unique to you, such as your ZIP code, age, gender, interests and favorites.

There is also information about your computer hardware and software that is automatically collected by Piedmont Triad Anesthesia. This information can include: your IP address, browser type, domain names, access times and referring website addresses. This information is used by Piedmont Triad Anesthesia for the operation of the service, to maintain quality of the service and to provide general statistics regarding use of the Piedmont Triad Anesthesia website.

Please keep in mind that if you directly disclose personally identifiable information or personally sensitive data through Piedmont Triad Anesthesia public message boards, this information may be collected and used by others. Note: Piedmont Triad Anesthesia does not read any of your private online communications.

Piedmont Triad Anesthesia encourages you to review the privacy statements of websites you choose to link to from Piedmont Triad Anesthesia so that you can understand how those websites collect, use and share your information. Piedmont Triad Anesthesia is not responsible for the privacy statements or other content on websites outside of the Piedmont Triad Anesthesia and Piedmont Triad Anesthesia family of websites.

Use of Your Personal Information
Piedmont Triad Anesthesia collects and uses your personal information to operate the Piedmont Triad Anesthesia website and deliver the services you have requested. Piedmont Triad Anesthesia also uses your personally identifiable information to inform you of other products or services available from Piedmont Triad Anesthesia and its affiliates. Piedmont Triad Anesthesia may also contact you via surveys to conduct research about your opinion of current services or of potential new services that may be offered.

Piedmont Triad Anesthesia does not sell, rent or lease its customer lists to third parties. Piedmont Triad Anesthesia may, from time to time, contact you on behalf of external business partners about a particular offering that may be of interest to you. In those cases, your unique personally identifiable information (email, name, address, telephone number) is not transferred to the third party. In addition, Piedmont Triad Anesthesia may share data with trusted partners to help us perform statistical analysis, send you email or postal mail, or provide customer support. All such third parties are prohibited from using your personal information except to provide these services to Piedmont Triad Anesthesia, and they are required to maintain the confidentiality of your information.

Piedmont Triad Anesthesia does not use or disclose sensitive personal information, such as race, religion or political affiliations, without your explicit consent.

Piedmont Triad Anesthesia keeps track of the websites and pages our customers visit within Piedmont Triad Anesthesia, in order to determine which Piedmont Triad Anesthesia services are the most popular. This data is used to deliver customized content and advertising within Piedmont Triad Anesthesia to customers whose behavior indicates that they are interested in a particular subject area.

Piedmont Triad Anesthesia websites will disclose your personal information, without notice, only if required to do so by law or in the good faith belief that such action is necessary to: (a) conform to the edicts of the law or comply with the legal process served on Piedmont Triad Anesthesia or the site; (b) protect and defend the rights or property of Piedmont Triad Anesthesia; and (c) act under exigent circumstances to protect the personal safety of users of Piedmont Triad Anesthesia, or the public.

Use of Cookies 
The Piedmont Triad Anesthesia websites uses “cookies” to help you personalize your online experience. A cookie is a text file that is placed on your hard disk by a webpage server. Cookies cannot be used to run programs or deliver viruses to your computer. Cookies are uniquely assigned to you, and can only be read by a web server in the domain that issued the cookie to you.

One of the primary purposes of cookies is to provide a convenience feature to save you time. The purpose of a cookie is to tell the web server that you have returned to a specific page. For example, if you personalize Piedmont Triad Anesthesia pages, or register with the Piedmont Triad Anesthesia website or services, a cookie helps Piedmont Triad Anesthesia to recall your specific information on subsequent visits. This simplifies the process of recording your personal information, such as billing addresses, shipping addresses, and so on. When you return to the same Piedmont Triad Anesthesia website, the information you previously provided can be retrieved, so you can easily use the Piedmont Triad Anesthesia features that you customized.

You have the ability to accept or decline cookies. Most web browsers automatically accept cookies, but you can usually modify your browser setting to decline cookies if you prefer. If you choose to decline cookies, you may not be able to fully experience the interactive features of the Piedmont Triad Anesthesia services or websites you visit.

Security of Your Personal Information
Piedmont Triad Anesthesia secures your personal information from unauthorized access, use or disclosure. Piedmont Triad Anesthesia secures the personally identifiable information you provide on computer servers in a controlled, secure environment, protected from unauthorized access, use or disclosure. When personal information (such as a credit card number) is transmitted to other websites, it is protected through the use of encryption, such as the Secure Socket Layer (SSL) protocol.

Changes to This Statement
Piedmont Triad Anesthesia will occasionally update this Statement of Privacy to reflect company and customer feedback. Piedmont Triad Anesthesia encourages you to periodically review this Statement to be informed of how Piedmont Triad Anesthesia is protecting your information.

Contact Information
Piedmont Triad Anesthesia welcomes your comments regarding this Statement of Privacy. If you believe that Piedmont Triad Anesthesia has not adhered to this Statement, please contact Piedmont Triad Anesthesia at web.payments@ptanc.com. We will use commercially reasonable efforts to promptly determine and remedy the problem.

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information.

Notice of Privacy Practices

This Notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
If you have any questions about this Notice, please contact our Compliance Director.

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or healthcare operations, and for other purposes that are permitted or required by law. It also describes your right to access and control of your protected health information. Protected health information (PHI) is information about you, including demographic information that may identify you and that relates to your past, present or future physical or mental health or condition, and related
health care services.

We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our Notice at any time. The new Notice will be effective for all PHI that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised Notice by accessing our website, www.ptanc.com, calling the office to have a revised copy sent to you in the mail or asking for one at the time of your next surgery.

 

1. Uses and Disclosures of Protected Health Information

Uses and Disclosures of Protected Health Information Based Upon Your Written Consent

You will be asked by your physician to sign a consent form. Once you have consented to the use and disclosure of your PHI for treatment, payment and healthcare operations by signing the consent form, your physician will use or disclose your PHI as described in this Section 1. Your PHI may be used and disclosed by your physician, our office staff and others outside of our offices who are involved in your care and treatment for the purpose of providing health care services to you. Your PHI may also be used and disclosed to pay your healthcare bills and to support the operation of the physician’s practice.

Following are examples of the types of uses and disclosures of your protected healthcare information that the physician’s office is permitted to make once you have signed our consent form. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office once you have provided consent.

Treatment: We will use and disclose your PHI to provide, coordinate or manage your healthcare and any related services, including the coordination or management of your healthcare with a third party that has already obtained your permission to have access to your PHI. For example, we would disclose your PHI, as necessary, to a home health agency that provides care to you. We will also disclose PHI to other physicians who may be treating you when we have the necessary permission from you to disclose your PHI. For example, your PHI may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

In addition, we may disclose your PHI from time to time to another physician or healthcare provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your healthcare diagnosis or treatment to your physician.

Payment: Your PHI will be used, as needed, to obtain payment for your healthcare services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we recommend for you, such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity and undertaking utilization review activities. For example, obtaining approval for a hospital stay may require that your relevant PHI be disclosed to the health insurance plan to obtain approval for the hospital admission.

Health Care Operations: We may use or disclose, as needed, your PHI in order to support the business activities of your physician’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, marketing and fundraising activities, and conducting or arranging for other business activities.

For example, we may disclose your PHI to medical school students who see patients at our office. In addition, we may use a sign-in sheet at the registration desk, where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment.

We will share your PHI with third-party “business associates” that perform various activities (e.g., billing, transcription services) for the practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.

We may use or disclose your demographic information and the dates that you received treatment from your physician, as necessary, in order to contact you for fundraising activities supported by our office. If you do not want to receive these materials, please contact our Compliance Officer and request that these fundraising materials not be sent to you.

Other Permitted and Required Uses and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to Object

We may use and disclose your PHI in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use or disclosure of the PHI, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is relevant to your healthcare will be disclosed.

Others Involved in Your Health Care: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary, if we determine that it is in your best interest based on our professional judgment. We may use or disclose PHI to notify or assist in notifying a family member, personal representative or any other person who is responsible for your care, of your location, general condition or death. Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts, and to coordinate uses and disclosures to family or other individuals involved in your healthcare.

Communication Barriers: We may use and disclose your PHI if your physician or another physician in the practice attempts to obtain consent from you, but is unable to do so due to substantial communication barriers and the physician determines, using professional judgment, that you intend to consent to use or disclose under the circumstances.

Health Oversight: We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the healthcare system, government benefit programs, other government regulatory programs and civil rights laws.

Coroners, Funeral Directors and Organ Donation: We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out his or her duties. We may disclose such information in reasonable anticipation of death. PHI may be used and disclosed for cadaveric organ, eye or tissue donation purposes.

 

2. Your Rights

Under federal law, however, you may not inspect or copy the following records: psychotherapy notes, information compiled in reasonable anticipation of, or use in, a civil, criminal or administrative action or proceeding, and PHI that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact our Compliance Officer if you have questions about access to your medical record.

You have the right to request a restriction of your PHI. This means you may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care, or for notification purposes, as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.

You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you, for a facility directory, to family members or friends involved in your care or for notification purposes. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter time frame. The right to receive this information is subject to certain exceptions, restrictions and limitations.

 

3. Complaints

You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Compliance Officer of your complaint. We will not retaliate against you for filing a complaint.

You may contact our Compliance Officer at (336) 768-3212 or compliance@ptanc.com for further information about the complaint process.