Arizona Digestive Health accepts all commercial, exchange, medicare replacement and student plans from the following insurers. If you do not see your insurance on the list, call your ADH Location to see if it has been recently added.
We require a copy of your current insurance card at the time of your visit. If you are unable to present your card before seeing the doctor, the visit may be considered fee for services, and full payment may be collected. If your insurance requires a co-payment, deductible, or co-insurance, it will be collected at the time of your visit. If you are an established patient, please verify all insurance information and notify us of any changes.
As a rule we try to verify all benefits prior to your appointment, but in some cases this is not possible. It is ultimately your responsibility to make sure you have insurance, we are an approved provider, you know what your benefits are, and you have supplied us with valid insurance information. When required, it is the responsibility of the patient to obtain all needed insurance referrals. In the event your insurance claim is denied, you will be responsible for the services rendered.
We will file any claims with your insurance carrier. When your insurance processes the claim we will make the appropriate adjustments. You may receive a bill after the insurance has paid if your benefits require you to pay a deductible, co-payment, or co-insurance that was not previously collected at the time of service.
It is our goal to make sure all patients understand how they will be billed before they receive their first statement. We understand that it can be quite confusing and we will work to help you understand all elements of the billing process. If you are having a procedure done in one of our affiliated Endoscopy Centers, there are many people and facilities involved in the success of your procedure and you will be billed for all the elements of the procedure. You may receive up to 4 (four) separate fees for different services. Below is a list of the potential groups or doctors that may bill you. All bills will be sent to your insurance carrier first. Any balances that the insurance does not pay will be your responsibility. If you are not sure what your insurance will cover please contact your insurance carrier for more information on your covered benefits.
This includes the facility fee that the Endoscopy center charges. This covers the cost for the staff, equipment, and supplies that are used during your procedure.
This is the bill for the physician’s time to conduct the procedure and it is billed from the Physician’s office.
These fees will be billed for anything that is sent to a laboratory for testing. This may include tissue samples, blood tests, or cultures. This fee includes two parts the handling of the sample and the reading by a pathologist.
Occasionally the services of anesthesiologist are required. You will be told if anesthesia is to be used ahead of time. The anesthesiologist will bill you for the medications administered and the physician’s time.
This is the total amount each provider has billed to your insurance provider
This is the total amount expected to be paid by the insurance and or the patient combined (also called the Negotiated Amount or Contracted Amount)
This is the amount that the primary insurance will pay.
This is the difference between the payable amount and the allowed amount. This represents any deductibles, co-payments, or co-insurance that you may be responsible for. If you have a secondary insurance they may pay for all or part of the patient responsibility depending on your benefits.