For billing purposes, there are four separate components for which your insurance will be billed separately:
1. Physician's Professional Charge. Your physician bills this charge separately to your insurance.
2. Facility Charge. The facility (hospital or ambulatory endoscopy center) will bill your insurance for the facility fee.
3. Pathology Charge. If a biopsy is taken during the procedure the pathologist will bill your insurance.
4. Anesthesia Professional Charge. The anesthesia provider will bill your insurance for the services provided during your procedure.
Please note: If you have an Out of State Anthem Blue Cross & Blue Shield, you must check with your carrier if they cover an Anesthesiologist for your Colonoscopy. These plans may not cover two doctors during the same operative session which could end up with additional out of pocket expenses. An alternative Anesthesia option is available with prior notification.
Under certain circumstances some insurance carriers may not cover or deny payment for services provided. Charges may be applied to your co-pay, coinsurance or high deductible plan.
It is the responsibility of the patient to contact their carrier for their benefits. We do not quote patient benefits or guarantee coverage by any insurance carrier.
Your carrier may cover a "Routine Preventative Colonoscopy Screening."
What is the definition of this type of screening?
A routine screening is for example, a patient who has been referred to our practice for a colonoscopy because that patient turned 50 and is asymptomatic (not having any medical issues, or any history of colo-rectal symptoms most commercial carriers will cover these routine preventative screenings, but you must confirm with your insurance carrier.
Your carrier may process your claim under your medical benefits.
If a patient has a history, such as adenomatous polyps, colon cancer, Lynch Syndrome or Inflammatory Bowel Disease, these colonoscopies will not be processed under the Routine Preventative Screening benefit but would be processed under your standard medical benefits which may or may not be subject to a deductible.
Questions to ask your carrier when obtaining benefits:
What is my coverage for a Routine Preventative Colonoscopy?
What is my coverage for a Colonoscopy if it is not considered to be a Routine Preventative Colonoscopy?
Effective January 1, 2020 Colon & Rectal Surgeons of Greater Hartford requires at least a 48-hour notification of the need to cancel a scheduled colonoscopy. If a 48-hour notice is not provided a $100.00 fee will be billed to you which is not payable by your insurance and will be your financial responsibility. To cancel please call our scheduling department at 860-242-8591 opt 2, between their normal business hours of 9:00am-4:30pm Monday-Friday.
I have read, and understand this financial disclosure presented to me by Colon & Rectal Surgeons of Greater Hartford.