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Billing and InsuranceWe recognize the need for a definite understanding between you and your physician concerning health care and the financial arrangements for this medical care. Our commitment is to provide the very best health care to our patients while recognizing the need to limit services to only those that are necessary. The responsibility for payment of fees for these services is the direct obligation of the patient. Any financial payment you may receive from private insurance or government agencies is a matter strictly between you and the insurance carriers or government agencies. Our physicians are participating Medicare physicians and do accept assignment on Medicare claims; however, any deductible, co-payment, or percentage not paid by Medicare or other carrier is your responsibility. It is also your responsibility to know if your insurance has specific rules or regulations, such as the need for referrals from primary care physicians, pre-certification, limits on outpatient charges, specific physicians and/or hospitals to use. You should be knowledgeable of any deductible, co-pay and / or percentage for which you are responsible. The same responsibility exists for HMOs or PPOs in which our physicians participate. Our receptionists and insurance clerks will assist you with filing your insurance.

Our fees reflect the time spent by the physician with you, the specialized-nature of the physician training, and the individual diagnostic studies performed. Our fees are comparable to other similarly trained specialists in the community. We will discuss fees with you at any time, and encourage you to inquire about a fee prior to receiving the service.

A facility fee is issued by the location where your procedure was done to cover the expense of the sophisticated equipment and nursing staff. This fee has been approved for coverage by Medicare, Medicaid, Blue Cross and Blue Shield, and other major insurance companies. Following your treatment at the Endoscopy Center, you will be mailed a separate facility fee statement. This means you will receive two bills - one for physician's services, the other for facility usage.

You will receive monthly statements. The first statement will show all charges, with subsequent statements showing any insurance payments (it takes 4-6 weeks for most carriers to pay). You are responsible for any unpaid balance.

Our office may verify insurance benefits and contact you to discuss our procedure fee.

NOTE: Some procedures that are performed in our office involve sending biopsy, cytology or laboratory specimens to the hospital pathology department for tissue analysis. When this occurs you will receive separate billings from both the hospital and/or the pathologist for their services.

Part of the increased cost of medical care is caused by an extraordinary amount of insurance paperwork. In fact, more than one of every four dollars spent on health care is needed to support administrative costs. In order to reduce these costs, which allows us to keep our charges as low as possible, we ask that you be prepared to pay for routine office visits when the service is rendered. Of course, the fees for care during hospitalizations or for specialized procedures can be paid on any mutually agreeable basis. Please let us know if you are having any particular financial problem - you will find us understanding and patient. Extra insurance forms, FMLA, letters to attorneys, etc., will necessitate an extra fee because of the paperwork and time involved.