Policies

Prescription Refill Policy

Our office requires you to come in for an office visit at least once a year if you are on continuing prescription medication. If you have seen us within the year and have no more refills on your medication, please have your pharmacy contact us to request a refill.


Insurance

GastroIntestinal Healthcare accepts most major insurances, including:

  • Aetna
  • Blue Cross & Blue Shield (excluding Blue Value and Blue Local policies – These are extremely narrow network policies which do not offer out-of-network benefit coverage. If you would like to see GIH become part of the Blue Value or Blue Local network, please contact BCBS to request we be added to these networks.) If you have a Blue Value or Blue Local policy, we can only see you as a self-pay patient.
  • Cigna (excluding Cigna Connect)
  • Coventry/First Health
  • Healthcare Savings
  • Humana Medicare (State Employees only)
  • Medcost
  • Medicare (Traditional)
  • Multiplan (PHCS – only through Multiplan)
  • United Healthcare
  • United Healthcare Medicare (State Employees only)
  • Railroad Medicare
  • Wellpath

We will file our charges directly with your insurance company. If your insurance is not listed, or if you do not have insurance, we will be happy to discuss how we can provide service to you.

 


Costs

Most insurances will cover the cost of the procedures, less any co-pays, co-insurance, and deductibles that may apply. As a courtesy to our patients, we provide each patient with a written estimate in advance of their procedure of potential out-of-pocket expenses associated with the procedure and insurance coverage, and un-met deductibles and co-insurance, if applicable.


Dependent upon the actual contract we have with your insurance provider, you may be responsible for the following fees:

  • Professional Fee– which is the doctor’s charge for performing your procedure.
  • Facility Fee– which is the charge for the procedure being performed in our endoscopy center.  (If your procedure is performed at the hospital, the hospital would bill your insurance company for this fee, which is usually higher than if performed in our endoscopy center.)
  • Pathology Fee– if the physician sends a biopsy to the pathology lab, the pathology lab will file their charges directly with your insurance company.  Our estimate does not include any potential pathology fee responsibilities.
  • Anesthesia Fee– is the charge for anesthesia services provided for your procedure.  If applicable, you may receive a separate invoice from Carolina Anesthesia.  Our estimate does not include any potential anesthesia fee responsibilities.

We strongly encourage patients to check directly with their insurance provider if they have questions about their benefits, and to determine whether a referral is required.


Financial Policy

We want to thank you for choosing GastroIntestinal Healthcare as your preferred healthcare provider.  We are committed to giving you the best care available.

Insurance

Your insurance policy is a contract between you and your insurance company.  We are not a part of that contract.  We do accept assignment of your benefits, however please be aware that some or all of the services provided may be a non-covered service under your plan. You will be responsible for these non-covered charges.  It is your responsibility to:

  • Ensure that we actively participate with your insurance carrier/plan
  • Know your benefit coverage
  • Ensure that all pre-approval requirements are met to avoid denials or out-of-network benefits.

Please remember that we must receive your billing information at the time of each visit in order to meet claims submission guidelines set by your insurance plan.  If either the practice or the plan fails to receive accurate information necessary to process your claim, you will be held responsible.

Regarding insurance plans where we are a participating provider, all co-pays and deductibles are due at the time of treatment.  In the event that your insurance coverage relates to a plan where we are not a participating provider, you will be 100% responsible for all charges incurred.

In summary, your financial responsibility pertains to:

  • Denied and non-covered services
  • Services deemed not medically necessary by your insurance company
  • Co-payments, deductibles, co-insurance
  • Pending claims due to lack of patient and/or guarantor information
  • Non-insurance and/or out of network benefits

Please be aware that if your insurance company has not paid within 45 days, your balance may be transitioned to patient responsibility.


Self Pay

Patient must pay in full at time of service.


Financial Services

CareCredit is a healthcare credit card designed for your health and wellness needs. Through the CareCredit program, GIH offers a 6-month, no interest payment plan option for balances over $200. For complete details of healthcare financing terms, please click on this CareCredit  link and review the CareCredit account agreement within the application.

M-Lend Financial offers patient financing with easy online registration.

  • You may contact them by calling: 1-888-474-6231, ext. 2
  • Or you may apply on-line at mlendfinancial.com

Missed Appointments

Please provide us with a 24 hour notice of cancellation so that we may utilize our schedule to provide better patient care.  If you don’t offer at least 24 hours advance notice, we may charge you a $25.00 missed appointment fee.  This charge will not be billed to your insurance company.


Collections

Any past due balances not paid may be turned over to a collection agency after 45 days.