Insurance & Billing
Participating Insurances
- AETNA/USHC
- AFFINITY
- AMERICAN PROGRESSIVE TODAY’S OPTION – MC PLAN
- BEECH STREET
- BLUE CROSS BLUE SHIELD (ALL PRODUCTS)
- CDPHP (ALL PRODUCTS)
- CIGNA
- Emblem Health
- EMPIRE PLAN (NYS EMPLOYEES)
- FIDELIS
- GHI (ALL PRODUCTS)
- GHI HMO
- HEALTH QUEST
- HEALTH NET
- HEALTHNOW
- HIP
- Hudson Health Plan
- HUMANA
- INDECS
- LOCAL 137
- LOCAL 825
- LOCAL 1199
- MAGNACARE
- MAXON
- MEDICAID
- MEDICARE
- MVP
- MULTIPLAN
- NATIONAL HEALTH ADMINISTRATORS
- OXFORD
- POMCO
- RAILROAD MEDICARE
- SENIOR WHOLE HEALTH
- TRICARE
- UNITED HEALTHCARE
- WELLCARE
Insurance Coverage and Payment Policy
If you have insurance coverage, it is important for you to know your out-of-pocket costs for payments not covered by your insurance such as deductibles, co-payments, co-insurance and non-covered services. At your first visit to the office you will be asked to review and sign our payment policy and agreement.
Payment Method
We accept payment by cash, check, VISA, MasterCard, and American Express. Payment is expected at the time of your visit.
Referrals and Pre-Certification
As a courtesy to you, we will contact your insurance company to obtain pre-authorization or pre-certification for procedures scheduled by our office. Pre-authorization and pre-certification are not guarantees of coverage and/or payment by your insurance company. It is your responsibility to contact your insurance company to determine the extent of your coverage for services. We can assist you by providing procedure code and diagnosis information that may be needed when you inquire about your coverage.
Uninsured Patients and High Deductible Insurance Plans
Patients without insurance or those having high-deductible insurance plans should contact our billing department prior to seeing our physicians in order to make payment arrangements before services are rendered. Advance payment is required for procedures and payment for office visits is due at the time of service.
Procedure Billings
If your physician performs an endoscopy procedure, you will receive two invoices; one for the physician’s professional services and the other for facility services.
The professional services billing will always be snet from Gastroenterology Associates and it reflects the services provided by your doctor. The billing for facility services will be sent from either a hospital or our own outpatient endoscopy center called Gastroenterology Associates.
If pathology work or anesthesia were also performed as part of your endoscopy procedure, you will receive separate billings from the entities providing those services.
Screening vs. Diagnostic Coverage
Insurance companies often provide screening coverage for routine screening colonoscopy. However, if during the course of your routine screening the physician removes a polyp or performs a tissue biopsy, the procedure may be considered diagnostic and may not qualify for coverage as a screening. In this case, you may be responsible for all or part of the procedure cost. It is important for you to discuss this with your insurance provider to determine your out-of-pocket costs in these instances.
Balance Due Statements
If you have a balance due on your account, you will receive an itemized statement from our office. Statements are mailed out weekly through first class mail. We trust that all mailed statements are received by our patients. Any questions regarding your statement may be direct to our Billing Department. The Billing Department may be contacted at 845-471-9410.