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Eligibility for our financial assistance program is determined without regard to sex, race, color, religion, ancestry, national origin, age, disability, medical condition, marital status, sexual orientation, gender identity, gender expression or educational background.

We honor the Financial Assistance and Charity Care award percentage determined by our surgical partners at the hospitals and ambulatory surgery sites across the country. Immediate approval is granted for an equal percentage awarded upon notification of approval from the partner site’s Patient Financial Services office.

Download the Financial Assistance Application form here

Email the form and proof of Financial Assistance Approval to: support@AnesthesiaBillPay.com

If a patient has not received their approval of Financial Assistance or Charity Care award from one of our partner sites, a patient can apply to our Financial Assistance program directly.