Billing

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Understanding your Financial Responsibilities

 

Introduction to New Health Insurance Policies

Due to the rising cost of health insurance, health plans are currently offering many new policies to make health insurance rates more affordable for employers and employees.  These insurance policies require patients to contribute more to the cost of their care through higher co-payments and larger annual deductible amounts before insurance coverage takes over.  These fees are independent from your health insurance premiums.

 

Why may I receive a bill from more than one source?

When a physician performs a procedure, there are separate and independent provider costs for that procedure.

  • Physician Fee
  • Facility Fee
  • Pathology Fee
  • Anesthesiology Fee

If you have concerns about the charges relating to your procedure date, please contact our billing office and they will be happy to explain the fees incurred.

 

When should I be Prepared to Pay?

It is your responsibility to know if your insurance requires referrals, co-pays, has deductibles or co-insurance cost.  Information about your plan can be obtained from your HR department, the plan website or calling the member services number on the back of your card.

  • Co-Payments are expected at time of service. The amounts should be clearly visible on your health insurance card.
  • Deductibles and co-Insurance amounts, when advised, will also be collected at time of service.
 

We at University Gastroenterology accept cash, checks, money orders, all major credit cards and CareCredit

 

Payment Options

 

CareCredit

CareCredit is a healthcare credit card designed for your health and wellness needs. It's a way to pay for the costs of many treatments and procedures and allows you to make convenient monthly payments. CareCredit is accepted at over 200,000 providers nationwide for your Gastroenterology Procedures, LASIK and Vision Care, Cosmetic and Dermatology Procedures, Dentistry, Veterinary, Hearing Care and other specialties. CareCredit is accepted at all of our facilities as an additional payment option.

Use it to pay for out-of-pocket expenses not covered by medical insurance, and special financing options are available that you may not be able to get with other cards.

With shorter term financing options of 6, 12, 18 or 24-months no interest is charged on purchases of $200 or more when you make the minimum monthly payments and pay the full amount due by the end of the promotional period. If you do not, interest is charged from the original purchase date.  CareCredit also extends longer term healthcare financing for 24, 36, 48 or 60-month periods with Reduced APR and Fixed Monthly Payments Required Until Paid in Full.

For complete details, see the CareCredit account agreement within your application.

Ask your provider to find out which promotion is right for you. You do not need to select a promotion before you apply.  **Subject to credit approval. Details and Terms

Should you need any assistance with the application process, promotional rates or just need clarification, please feel free to contact CareCredit at 1-800-677-0718.

To Apply By Phone

Call 1-800-677-0718 (must be 21 and over)

Find out immediately if you have been approved by using CareCredit’s easy, automated system anytime.  Apply with a live agent Monday through Friday from 9AM- 9PM (EST).

If you’re an active cardholder and would like to make a payment, please call our billing department at 401-324-8001.

 

Patient Portal

Coming soon, we are working to add payments to our patient portal and expect to have this feature available by May 2019.

 

Telephone

 

You may call our billing team with any questions at 401-324-8001.

 

No-Show/Late Cancellation Policy

University Gastroenterology reserves the right to charge a fee for appointments that are NOT KEPT or CANCELLED with less than 48 hours notice.

  • Office Visits will be subject to a $50 fee
  • Procedures will be subject to a $100 fee
 

 

Frequently Asked Questions

 

What is a deductible?

A deductible is an annual expense a patient pays before a health plan begins to cover your healthcare expenses. For example, each year you may be responsible for paying the first $1000.00 of the expense before your health plan coverage begins to make payments. This is your shared cost of your insurance.

 

What is a copay?

A copay is a specific amount a patient pays for a service. For example, a $25 copay for an office visit with a specialist.

 

What is a co-insurance?

A co-insurance is a percentage of a health care expense for which a patient is responsible for paying. For example, your health insurance may pay for 80% of the cost and the patient is responsible for 20% of the cost. This is your responsibility for costs after your insurance deductible is met.

 

What is a non covered service?

A non covered service is any service that are not included under the terms of a patient's health insurance policy, but are determined to be medically necessary. This becomes the financial responsibility of the patient.

 

When should I be prepared to pay?

It is the patients responsibility to know if your insurance has any copays, co-insurances and/or deductibles. Information about your plan can be obtained from your HR department, the plan website or calling the member services on the back of your insurance card. The patient should be prepared to pay at the time of service. You may be notified by our billing agency by phone and/or letter with an approximate amount due at the time the service is rendered.

 

Who will be billing me and/or my insurance carrier?

When a physician performs a procedure, there are separate and independent providers who may be involved in your care. Costs from these necessary additional providers may occur with your procedure. These may include: Physician Fee, Facility or Hospital fee, Pathology fee, Anesthesiology fee. If you have any questions on who may be involved with your care, we are pleased to review this with you prior to your procedure. Please call 401-324-8001.

 

What is a referral?

A referral is generated by your PCP's office to the specialist. It is the patient's responsibility to know if your insurance requires a referral and it is the patient's responsibility to obtain that referral if needed from your PCP’s office. If a referral is not obtained within 48 hours, your appointment may be cancelled.

 

What is a prior authorization?

A prior authorization for a service, is one that needs to be approved by your health plan prior to receiving that service. A prior authorization is the responsibility of the provider. Our billing service will contact your plan to obtain the prior authorization.

 

What is a screening colonoscopy?

A colonoscopy done in the absence of symptoms or abnormal testing.

 

What is a diagnostic colonoscopy?

A diagnostic colonoscopy is when the patient presents with any signs or symptoms. It could also mean a colonoscopy done for a history of colon polyps, positive cologuard or other colon cancer screening tests.

 

What is high risk screening colonoscopy?

A high risk screening colonoscopy is when a patient has a family history of colon cancer in a first degree relative, also patients with genetic disorders and long standing inflammatory bowel disease. A personal history of colon polyps is not considered a high risk screening with most insurance carriers.

 

Can a Physician change, add or delete a diagnosis so that I can be eligible for a colonoscopy screening?

No. This is insurance fraud.

 

What is an ABN?

An ABN is an Advance Beneficiary Notice, also know as a waiver of liability. The ABN allows you to decide whether to get the care in question and to accept financial responsibility for a service that is not covered under your insurance plan.

 

Who should I contact with questions?

Any billing related questions can be addressed with our billing company by calling

 

 

What facilities may bill me?

If your outpatient procedure is being performed at an ambulatory facility, you may receive a bill from one of the Endoscopy Centers listed below. If you have any questions as to what your out of pocket costs are for the facility fee, please contact the facility directly. They will be able to assist you.

  • Bayside Endoscopy Center, 33 Staniford Street Providence, RI : 401-274-1810
  • East Bay Endoscopy Center, 109 Clock Tower Square Portsmouth, RI: 401-293-5400
  • East Greenwich Endoscopy Center, 1407 South County Trail E Greenwich, RI: 401-885-2760
  • Ocean State Endoscopy Center, 148 West River Street Providence, RI : 401-421-6306

If your outpatient procedure is being performed at a Hospital, you may receive a bill from one of the Hospitals listed below.

  • Rhode Island Hospital: 401-444-4000
  • Kent County Hospital: 401-737-7000
  • Newport Hospital: 401-846-6400
  • Miriam Hospital: 401-444-3500
  • Roger Williams Hospital: 401-456-2002