Insurance & Billing Information
PA GI is a participating provider with many major health insurance plans, as well as Medicare. Listed below is a list of insurance plans we currently accept. This is not a complete list. Please check with your insurance plan to verify coverage.
- Aetna Better Health
- Aetna Medicare
- Capital Blue Cross
- Gateway Medicare
- Geisinger Medicare
- HealthAmerica Coventry
- HealthAmerica Advantra
- Health Net Federal Services
- Highmark Freedom Blue
- South Central Preferred
- Railroad Medicare
- United Healthcare
- United Healthcare Community Plan
- VA Patient Centered Community Care
* Insurance participation is subject to change. Please contact your insurance company to verify coverage.
Understanding What’s Covered By Insurance
Your insurance policy is a contract between you and your insurance company. While we are dedicated to providing the best possible care, not all services are covered benefits in all contracts. It is your responsibility to be aware of the non-covered services and verify deductibles, etc.
Our staff will be happy to answer any questions you have regarding tests that have been scheduled and will try to assist you with information you may need to verify coverage.
Valid insurance cards need to be presented at the time of your appointment. If you do not have your insurance card, we will expect payment at the time of the visit. After presentation of your card we will be happy to bill your insurance company.
Please be aware that an authorization from your insurance company is not a guarantee of payment. You are responsible for any balance that remains after your insurance benefits.
CO-PAYMENTS AND ACCOUNT BALANCES
Co-payments must be paid at the time of the visit. If we must bill you for your co-payment, we will add a $5.00 processing fee. An additional $25.00 will be charged for returned checks.
Our office participates with Medicare. Patients are responsible for the deductible and co-insurance at the time of service. If you have secondary coverage to Medicare, we will file that claim for you.
Patients who are uninsured are expected to make arrangements with the billing department in advance of their appointments. Extended payment plans can be arranged. A one-time $5.00 fee will be charged, and a written agreement will need to be signed by the responsible party. An additional $25.00 will be charged for returned checks. For your convenience we accept Visa and MasterCard.
Billing Guideline for Screening Procedures
Routine colorectal cancer screening services are covered by most insurance companies and Medicare. Always check with your specific insurance plan. The goal of screening colonoscopy is to identify and remove colon polyps or sample visible abnormalities if discovered at the time of the screening colonoscopy. Insurance coverage for screening colonoscopy does not include the removal of polyps or biopsy. Therefore, your coverage may change and you may be responsible for your portion of the insurance coverage based on your specific insurance plan.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 717 763-0430 ext 319.