Here at GastroIntestinal Healthcare, we pride ourselves on providing each patient a smooth, caring experience, from when you step out of your car in the parking lot until you step back into the car after your appointment (hopefully with a satisfied smile on your face!). We also pride ourselves on giving top notch quality care in a cost-effective manner. We know money doesn’t “grow on trees” and we don’t want lack of funds to deter someone who needs the services we provide. We also don’t want you to have to decide between paying your rent this month or getting the colonoscopy you need. That’s why we’ve proudly displayed our Tier 1 status with several insurance companies on our website, which acknowledges that we provide high quality care in a cost-effective format.

But we go further than that. We are committed to providing each patient a comprehensive estimate of what you will be paying out of pocket for a recommended procedure before you leave our office. This estimate is based on your particular insurance plan’s coverage for the services you need.

The estimate includes three parts: the physician fee, the facility fee, and the anesthesia fee.

The procedure physician fee is the charge for the physician to perform the procedure.

The facility fee covers the costs associated with using the endoscopy the endoscopy center where your procedure will be performed. This fee goes toward state-of-the-art equipment, medical supplies and drugs, and operating expenses of the center. It also goes toward maintaining the highest infection control standards in the industry for our equipment. Our facility is considered in- network with all of the insurance plans accepted at our practice.

Anesthesia providers assist us during your procedure by administering medications that keep you comfortable and monitoring your vital signs, such as breathing, heart rate, and blood pressure. They bill separately for their services. We provide their contact information to every patient before the procedure so you can call them with questions about your estimate. The good news is that all of our anesthesia providers, like our facility, are considered in network with the insurance plans accepted in our office. So not only do all of our anesthesia providers keep you comfortable during your procedure, but they are easy on the pocketbook, too!

One potential fee not included in your estimate is pathology. Like anesthesia, the pathology lab is a separate service. This will only be used if biopsies are taken during the procedure or polyps are removed. You will get a separate bill from the pathology lab in that case. This is a service for which we can’t provide an estimate, since the cost depends on what is found during your procedure.

Because medical billing can be tricky and difficult to understand (even for the people who do it every day), we want to be very transparent by telling you that your out of pocket cost may change depending on what we find in your colon. The most common reason for this is if you’re coming in to get screened for colon cancer and we find polyps in your colon. Many insurance companies calculate benefits based upon the results of the procedure, at which time an insurance company may deem your colonoscopy to be diagnostic and not a screening. We will do our best to help you understand all of your plan’s benefits when it comes to getting a colonoscopy, but if there are questions our staff aren’t able to answer, you may need to call your insurance company for clarification. Remember, our goal is to make sure you get the care you need in the most cost-effective way possible, and we are happy to work with you to achieve that.

We hope this clears up some of the questions you may have about your bill before your procedure. Our staff is always available if you have other questions or concerns.