Billing & Insurance
Insurance Information
We know that health care insurance can be confusing. Please take a brief moment to review this page to help you understand some key points about your insurance as it relates to your procedure at The Center for Digestive Health. If you have further questions, please contact one of our trained Billing and Insurance staff who will be happy to answer your questions.
Payment of co-pays, coinsurance and any deductible amounts that are due are expected upon your check in to the center. A description of each is as follows:
- A co-pay is a form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. The insurer is responsible for the rest of the reimbursement. There may be separate co-payments for different services. Some plans require that a deductible first be met for some specific services before a co-payment applies.
- A deductible is a fixed dollar amount during the benefit period (usually a year) that an insured person pays before the insurer starts to make payments for covered medical services. Plans may have both per individual and family deductibles. Some plans may have separate deductibles for specific services. For example, a plan may have a hospitalization deductible per admission. Deductibles may differ if services are received from an approved provider or if received from providers not on the approved list.
- Coinsurance is the amount due by the patient after the insurance has paid and applied all deductibles and co-pays. This is the amount that is usually described as "Patient Responsibility" or "Member Responsibility" on the Explanation of Benefits. It is usually a percentage of the allowed amount covered by your insurance (i.e. 80/20; 70/30; 90/10). Because we contract with many insurance carriers, we can many times determine the patient’s coinsurance in advance based on the information received by your physician’s office at the time of scheduling.
Procedure Billing Information
Because there are several health care practitioners who are providing a service to you, there will be separate bills generated from each of these providers; therefore, you can plan to expect bills from multiple providers for one procedure at our surgery center.
- A bill from GenGastro LLC, which is the facility fee for the procedure.
- You will also receive a bill from your physician: Gastroenterology Associates, P.C.
- If pathology is necessary, you will also receive 2 additional bills; one from the Pathology Lab and one from the Pathologist.
The Center for Digestive Health will bill your procedure to your insurance company for their portion, and to a second insurance provider, if you have one.
Ultimately, you are responsible for the charges associated with your procedure. If after the procedure, we discover that you have over paid us, we will issue you a refund.