Gastroenterology - Frequently Asked Questions
- How do I make an appointment with a gastroenterologist in your office?
- What is your cancellation policy?
- What information should I bring to my office appointment?
- Will I need to wait to see the physician?
- How do I speak to my gastroenterologist?
- What do I do if I have a question about the preparation or if I am having a problem with the preparation for my procedure?
- Where are you located?
- How do I reach you in an emergency?
- What is a Co-Pay?
- What is a deductible?
- What is an Insurance/Medicare waiver?
- From a billing standpoint, what is the difference between a screening colonoscopy and a diagnostic colonoscopy?
- What is the difference between professional services and facility services?
- When do I need prior authorization or referrals?
- What if I have billing questions?
How do I make an appointment with a gastroenterologist in your office?
Save time on the phone by filling out our booking form to get a call back. Please note that we are unable to schedule appointments via email. If you prefer then please call directly on 617-969-1227.
What is your cancellation policy?
What information should I bring to my office appointment?
- Insurance card/information
- Insurance copay, if required
- Completed confidential medical history questionnaire (for new patients to the office and patients not seen in the past 3 years)
- Forms (Please review this page and bring the appropriate forms and documents)
Will I need to wait to see the physician?
Gastroenterologists take care of a variety of different conditions. Some of these conditions require urgent or emergency attention. Occasionally this can delay or interfere with an office visit. Please understand we will do our best to notify you of a delay and do our best to be on time. We understand your time is valuable.
How do I speak to my gastroenterologist?
Please call the office at 617-969-1227 and leave a message with one of our medical secretaries. We will return your call in a timely manner. We are often not able to answer phone calls immediately as we are doing procedures or seeing patients in the office.
What do I do if I have a question about the preparation or if I am having a problem with the preparation for my procedure?
Where are you located?
How do I reach you in an emergency?
We can be reached during business hours at 617-969-1227. If you are experiencing a medical emergency, dial 9-1-1.
What is a Co-Pay?
This is the amount you must pay during each visit with your physician. The amount may vary from one insurance to another, and from one year to the next. Often the amount is clearly noted on your insurance card. The copay is required by your insurance company and payment is required at the time of your office visit.
What is a deductible?
This is an amount you need to pay out of pocket in its entirety at the beginning of the year. This may apply to certain insurances and does apply to Medicare beneficiaries. For Medicare beneficiaries, secondary insurance may or may not pick up the deductible. Our staff will help you with filing your insurance as necessary.
What is an Insurance/Medicare waiver?
- Some commercial insurances and Medicare do not cover routine visits or certain tests or procedures. They will only pay for services deemed by them to be reasonable and necessary. If any service deemed necessary by the physician is denied for payment by your insurance company or by Medicare, you are responsible and agree to pay for our services fully and in a timely manner.
- We bill once a month. Before billing you for any balance, we will exhaust all means to get paid for our services by your insurance company. All outstanding balances are due within 30 days. Outstanding balances of more then 90 days are subject to collection proceedings.
- We accept cash, money orders, personal check, and major credit cards (American Express not accepted). There will be a charge for all returned checks.
From a billing standpoint, what is the difference between a screening colonoscopy and a diagnostic colonoscopy?
If your colonoscopy has been scheduled for a screening (i.e., you have no symptoms with your bowels*), and your doctor finds a polyp or tissue that has to be removed during the procedure, this colonoscopy is no longer considered a screening procedure. It is considered a surgical procedure and your insurance benefits may change. It is your responsibility to check with your insurance company prior to your procedure date to assure that you understand your insurance benefits and coverage.
- *Symptoms such as change in bowel habits, diarrhea, constipation, bleeding, anemia etc.
What is the difference between professional services and facility services?
If your physician performs an endoscopy procedure, you will receive two invoices; one for the physician’s professional services and another for the facility services.
- If pathology work or x-rays were also performed as part of your endoscopy procedure, you will receive separate billing from the entities providing those services.
- The professional services billing will always be sent from Gastroenterology HealthCare Associates, and it will reflect the services provided by your doctor. The billing for facility services will be sent from the hospital where the procedure was performed. If you have any questions regarding the facility charges, you must contact the facility directly.
When do I need prior authorization or referrals?
- As a courtesy to you, we will contact your insurance company to obtain prior authorization of procedures scheduled by our office. Prior authorization is not a guarantee 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.
- If your insurance coverage requires you to have a referral from your Primary Care Physician it is your responsibility to contact the PCP office prior to your procedure to obtain the referral.
What if I have billing questions?
As always, if you have any questions, feel free to contact our billing office at 617-614-6070.