Policy Payment for Services

 

Insurance information will be obtained and coverage verified.  Patients will be informed of the anticipated cost to them prior to the procedure and will be requested to pay their co-pay / deductible amounts prior to the procedure.   Claims will be filed in a timely manner to the insurance company.  Any additional amounts that the insurance deems the patient is responsible will be billed within 30 days.  Patients will be required to pay the full balance unless the patient contacts the office and a payment plan is arranged.  Billing statements to patients are itemized.  Requests for billing statements for the past three years will be honored.

A patient or patient representative may dispute a bill by contacting our office and speaking with the Insurance Manager.  The Insurance Manager will pull the EOB’s that were received with payment and review the account.  If it is found that an error was made by Gastroenterology East, it will be corrected immediately.  Gastroenterology East will call the patients insurance company and verify if payment was made in accordance with the patients plan.

A patient or patient representative may not appeal a decision made by Gastroenterology East regarding their bill. Gastroenterology East will not bill a patient for more than what their insurance company holds them responsible for.

If at the time of service the patient has overpaid and is due a refund, a refund will be processed within 45 days of the insurance payment. Patients may request a refund when they receive their EOB from their insurance company, but Gastroenterology East will not provide a refund to a patient until payment from their insurance company has been received.  Refund checks are issued once a month.

Any patient that has a balance over 60 days old and has not contacted our office to set up payment arrangements will be sent to a collection agency.  Once the aging on their account reaches 60 days with no payment, patients will receive a final notice stating they have 15 days to contact our office to make payment arrangements.  If no contact is made, the patient will be sent to a collection agency at the beginning of the next month.

 

If a patient does not have health insurance, they are considered a self-pay patient.  Self-pay rates are discounted as follows:

Initial Office Visit

  • Referred by Doctor – $233
  • Self-Referred – $131

Return Visit

  • $80.00

Colonoscopy (screening or diagnostic)

  • Screening/Diagnostic (includes all Biopies) – $1,500.00

Upper Endoscopy (EGD)

  • Includes all Biopsies – $1,200.00

CT Scans

  • Price per body region – $400.00