By: Lisa Rosselli, CPC
We understand that medical billing and insurances can be confusing, especially when you don’t feel well. Our billing staff is continually working to improve our processes to meet the needs and expectations of our patients. Listed below are some of the frequently asked billing questions that may help prepare you for your visit:
I need to have a colonoscopy. How much will it cost?
The cost will vary depending on your treatment plan. We are able to give you an estimate prior to your procedure. The estimate will consider the professional services provided by your Digestive Disease Associates physician. We recommend you contact your insurance company before your procedure for questions about what is covered and any out-of-pocket expenses such as deductible, coinsurance, and/or copayment. Our staff will gladly provide you with the procedure and diagnosis codes that you can give to the insurance representative.
Is Digestive Disease Associates the same as Berks Center for Digestive Health?
Digestive Disease Associates is a doctors’ office and Berks Center for Digestive Health is an ambulatory surgery center. You may come to Digestive Disease Associates for an office visit. Berks Center for Digestive Health is the facility where you may have your gastroenterology procedure.
I had a colonoscopy and polyps were removed. It was one procedure so why did I receive several bills?
Your Digestive Disease Associates physician who performed the colonoscopy would have billed your insurance for the professional fee. There are other entities that are integral to your procedure. Some of these may include the facility where your procedure was done, the anesthesiologist who provided your anesthesia, and the pathologist who examined your polyps. If you have questions concerning any of these services, please contact that specific provider or your insurance company.
I received a bill from Digestive Disease Associates. Can I pay it on-line?
You can pay a bill from Digestive Disease Associates on-line by visiting our website: www.ddaberks.com and selecting the Patient Portal. You can also pay on-line at www.paymydoctor.com. This information can be found on your billing statement.
I thought I was having a screening colonoscopy but it was billed as diagnostic. Why did this happen?
If you were having any symptoms, such as diarrhea, abdominal pain or rectal bleeding when your colonoscopy was ordered, it would be billed as diagnostic. A screening colonoscopy is performed on patients who have no symptoms and need to be checked for colorectal cancer or polyps. Please check with the provider who ordered the procedure if still have questions.
What are my options if I can’t pay my bill in full?
Our billing staff can work with you to arrange a monthly payment plan so you can pay your bill over an acceptable period of time.
I think my insurance requires a referral. What should I do for my appointment?
If your insurance plan requires a referral, please contact your primary care physician’s office and ask them to send one to our office before the appointment. Most referrals can be done electronically which means your primary care physician can send it directly to our office by fax or through your insurance company’s website. You can receive the highest benefits from your insurance if we have the referral for your appointment.
I have a high deductible insurance plan and I need a colonoscopy. Will my insurance pay for it?
If your plan has a deductible, it must be met within the benefit period before the insurance will pay for any covered services. We recommend you contact your insurance to verify if you have met your deductible or if there is a portion remaining.
I had a colonoscopy and my doctor wants to repeat it because he couldn’t do a complete exam. Will my insurance pay for another one?
If you had a colonoscopy and the physician was not able to visualize the entire colon due to unforeseen circumstances, we will bill it as an incomplete exam. Your insurance should allow a repeat exam, but we recommend you contact them and check your benefit plan.
Does Digestive Disease Associates participate with my insurance?
Digestive Disease Associates participates with most major insurance companies. You may contact our office to inquire or check the list of participating insurances on our website at: www.ddaberks.com listed under Office. For your convenience, we will submit a claim to your insurance for any services you receive at Digestive Disease Associates.
No matter how big or small, our billing staff is here to listen and help resolve your question or problem. Sharing your concerns give us opportunities to improve our services to patients. We are available to address your billing questions Monday through Friday, 8:00 am to 4:30 pm at 610-374-4401, option 4.