Insurance Carriers

We participate in most of the insurance products from the following insurance carriers*:

  • Aetna/Coventry
  • BlueCross BlueShield (BCBS)
  • Cigna
  • Humana
  • MedCost
  • Medicare
  • Medicaid
  • North Carolina State Health Plan
  • Primary PhysicianCare
  • United Health Care (UHC)
  • Well Path (Coventry and First Health)

If your carrier is not listed above then please call our Insurance Department at 704-783-1840 for clarification. We will be happy to provide you with your coverage determination.

* subject to change

 

See our frequently asked insurance questions.

 

We perform charitable medical care to low-income uninsured patients through Community Care Plan. Read more about our Indigent/Charity Care Policies and Procedures.

 

Billing

 

Office Visits-Consultation

Out of pocket (co-pays/deductible) per your insurance plan will apply to these services.

 

Procedural Services

Endoscopy services are surgical procedures and will be processed under the surgical provision of your insurance plan. While the procedures are most often just diagnostic nature, they are not considered a diagnostic test by the insurance carrier, nor the American Medical Association. Some insurance plans have exclusions for out-patient surgical procedures or have different out-of-pocket expenses based on the location where the procedure is performed. Deductibles may apply.

 

The fees associated with endoscopic services that you can expect to billed for include:

  • Professional fee for the physician’s services (Northeast Digestive Health Center/Cabarrus Gastroenterology Associates, PLLC)
  • Facility fee for use of the surgery facility which provides the equipment and monitoring (Northeast Digestive Health Center/Cabarrus Gastroenterology Associates, PLLC, Gateway Surgery Center or CMC-NorthEast Hospital)
  • Fee for pathology services if a tissue sample is submitted for analysis (Endochoice or CMC-NorthEast Pathology)
  • Fee for anesthesiology services that are rendered during your procedure.

 

PreCertification/Authorization/Estimated out of pocket

The correct insurance information must be reported to Northeast Digestive Health Center at least 7 days prior to the procedure to allow time for pre-certification. Failure to report the correct insurance may result in you being responsible for the full balance due.

 

A member of the Insurance Department of Northeast Digestive Health Center will contact your insurance carrier to see if pre-certification is required for the procedure to verify benefits and obtain an estimated out of pocket amount. Please note that pre-certification and estimated out of pocket is not a guarantee of payment as per your insurance company.

 

We strongly encourage you to call your insurance carrier to confirm your benefits for the procedure that has been scheduled as well as verifying that pre-certification has been granted if it is required. Be sure to have them review the “screening and/or findings” diagnosis as some plans have limited coverage based on diagnosis.

 

Also, if you are scheduled for a screening colonoscopy and our findings require treatment, this could change your benefits and your out of pocket expenses.

 

 

 

gPORTAL

Patient Portal

Northeast Digestive Health Center offers an interactive, secure online portal for patients. Convenient and easy to use, the patient portal lets you request appointments online, email physicians, view test results, update personal medical records and even complete paperwork before your first visit with us!

 

AAAHC