Insurance and Billing Process Overview

It is your responsibility to confirm your insurance benefits with your insurance plan(s) prior to your clinic visit or procedure. If your insurance plan(s) require(s) a co-payment for your appointment, the co-payment is due at the time of your appointment. To ensure accurate billing, you will be asked to provide current insurance information and photo identification each time you check in for an appointment at one of our offices. Failure to present your current card(s) will release CFG from any responsibility for incorrect or untimely filing of contracted claims. Please alert our reception staff of any changes in insurance or personal information.

Pre-Certifications and Prior Authorizations

If your insurance plan(s) require(s) pre-certification or prior authorizations, you are responsible for making sure all proper referral and preauthorization information is obtained prior to your procedure. You will need to provide this information to CFG when you have obtained

Referrals

If your insurance plan(s) require(s) a referral, you are responsible for obtaining this referral from your primary care provider or clinic prior to your appointment.

Claims Submission and Billing

If you have provided us with insurance information, we will submit claims to your insurance plan(s) and will assist you in any way we reasonably can to facilitate getting your claims paid. However, your insurance plan(s) may need you to supply certain information directly and it is your responsibility to comply with this request.

Once your insurance claims have been processed by your insurance plan(s), a statement will be sent to you for any deductible, co-insurance, co-payment or other remaining balance not paid by your insurance plan(s). The final amount owed by you is dependent upon your insurance carrier and the plan that you have with them.

There will be a charge from the physician:

  1. After your insurance has processed the charge from us, you will receive a
    statement from the Center for Gastroenterology

There may be a charge for pathology:

  1. If you have a biopsy taken during a procedure you will receive two statements.
    One from the pathologist and one from our office.

    1. Summit Pathology: 877-268-0407

 There will be a charge for the facility:

  1. Patients may have their procedure performed at one of the following facilities:
    1. Poudre Valley Hospital: 970-495-7254 Estimate Line- 970-495-7222
    2. Harmony Ambulatory Surgery Center: 970-297-6431
    3. Skyline Endoscopy: 970-663-2159
    4. Medical Center of the Rockies: 970-624-2500
    5. Estes Park Medical Center: 970-577-4678
    6. McKee Medical Center: 970-669-4640
    7. Greeley Surgical Center: 970-624-2500

There may be a charge from an anesthesiologist:

  1. If you have any anesthesia during your procedure, you will receive a
    statement from the anesthesiologist.

    1. Northern Colorado Anesthesia (for Harmony Ambulatory): 970-
      224-3985
    2. Banner Medical Group Specialists: 970-395-7878
    3. For Skyline Endoscopy Only – Anesthesia is billed by Centers for
      Centers for Gastroenterology

The Centers for Gastroenterology cannot quote or guarantee payment from your insurance carrier. Please contact them directly to verify benefits for your scheduled services.

SOME INSURANCE PLANS may have a benefit for screening colonoscopies.  If you are scheduled for a screening colonoscopy and a polyp is found it will be removed, or if the physician finds an abnormality a tissue sample may be taken. If any tissue is removed then your procedure is NO LONGER a screening exam and it becomes diagnostic. We will bill your procedure with the primary diagnosis of screening as this is the intent of your procedure and the secondary code would be the findings (e.g. polyp). Your pathology will be billed as diagnostic. It is best to contact your insurance company and ask what your benefit is for a screening colonoscopy as well as for a colonoscopy with polyp/tissue abnormality removal if you have any questions concerning this.

Should you have any additional questions regarding this notice, please contact a patient financial representative at the Centers for Gastroenterology.

Payment

Payment in full is due upon receipt of your statement. We accept payment by credit card (Visa, MasterCard and Discover), personal check or money order. If you wish to make a payment online, please click here.

If you are unable to pay your balance in full, it is your responsibility to contact our Financial Representatives at 970-207-9773 to establish a mutually agreeable, interest-free payment plan as soon as possible.

 

Contracted Insurance Plans

The following is a list of many of the insurance plans with which we participate.  Please contact your insurance plan prior to your appointment to determine your specific coverage and benefits.

We are contracted with these payors but not all the plans they provide. It is your responsibility to confirm with your insurance company to be sure that your plan is in-network with CFG.

 

AARP

Aetna

Banner Health

BCBS

Cofinity

Colorado Access Medicare Advantage

Colorado Choice Health Plan

Coventry/First Health

First Choice of the Midwest

GEHA

GWH Cigna

Humana Medicare

Kaiser Permanente HMO & Medicare

Medicaid (Colorado)

Medicare (part B)

Medicare Railroad

Rocky Mountain Health Plans

Sanford Health Plan

Tricare/Triwest

United Healthcare

Secure Horizons

Fees & Insurances

Our office staff makes every effort to be well informed regarding insurance plans, however, it is your responsibility to be familiar with the requirements of your particular insurance plan and to supply us with accurate information at all times.