Most Commonly Asked Questions

Why do I have to fill out new paperwork every time I come in?

Our providers need to have the most up-to-date information in order to make the best decision for your treatment. Examples: You may have been prescribed a new prescription or stopped taking one. New symptoms may have arisen or previous symptoms may have changed. By updating this information it allows you to receive the proper and most successful treatment.

General Insurance information.

Your insurance policy is an agreement between you and your insurance company. Our relationship is with you, not your insurance company. Therefore, all charges are ultimately your responsibility, regardless of your insurance status. You are responsible for making sure all proper referral and preauthorization information is obtained prior to your procedure.

Do you take my insurance?

There are many insurances and within each insurance, there can be limited plans. Please contact your insurance to make sure that Centers for Gastroenterology is in the network. It is recommended any time you speak with an insurance company obtain a reference number and name of the person you spoke with for your files.

Will my colonoscopy be paid for at 100%?

Again, you will need to contact your insurance directly as each insurance and each policy has its own guidelines. Please let the representative know if you have had previous polyps, rectal bleeding, age, etc. as this can determine how an insurance company will pay for your colonoscopy. It is recommended any time you speak with an insurance company obtain a reference number and name of the person you spoke with for your files.

My insurance plan told me that you coded my procedure incorrectly and they won’t pay. Why won’t you change my diagnosis (ICD) code?

Centers for Gastroenterology strives to be consistent and compliant with the federal coding regulations set forth by the Centers for Medicare and Medicaid Services (CMS). We are not able to change coded charges in order to manipulate payment methodologies set forth by insurance companies.

How many bills can I possibly expect with my procedure?

As you prepare for your procedure, we want to make sure you understand how you will be billed for the services that you receive. At a minimum, you will receive two separate bills. One bill will be from the Centers for Gastroenterology for your physician’s fee, and the other will be from the facility where your procedure is performed. If you have polyps removed or other biopsies taken, you will receive additional bills from the appropriate provider listed below for the anesthesia services and/or the pathology services.

We will file our physician’s fee with your insurance carrier based on the information you provided at the time of scheduling. The final amount owed by you is dependent upon your insurance carrier and the plan that you have with them. Once our claim has been processed, the Centers for Gastroenterology will send you a bill for any remaining balance due.

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 forCenters 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.

Why do I need to have a driver after my procedure?

Per Colorado State Regulations you must have a responsible adult (must be 18 years of age or older) with you upon discharge that can drive you home. It is recommended that you have a responsible adult with you for 24 hours after your procedure. This is for your safety and protection. You are not allowed to take a taxi or bus.

If you do not have someone who is able to drive you, please contact the facility your procedure is scheduled with and they might be able to provide you with approved caregivers.

Your procedure may be canceled by the facility if this requirement is not addressed.

Here is a list of transportation services:

If I need to cancel or reschedule my procedure appointment, who do I need to contact?

Please contact the facility you are scheduled at unless otherwise noted.

• Harmony Surgical Center – 970-297-6366   https://harmonyasc.com/
• Skyline Endoscopy Center – 970-663-2159 https://www.skylineendocenter.com/
• Estes Park Medical Center – 970-577-4678 https://www.epmedcenter.com/
• Poudre Valley Hospital – contact Abby at 970-207-9773 ext 70866
• Medical Center of the Rockies – contact Carolyn at 970-669-5432 ext 46288
• McKee Medical Center – contact Carolyn at 970-669-5432 ext 46288
• Greeley Surgical Center – contact Carolyn at 970-669-5432 ext 46288

Do I have to pay if I see a Nurse Practitioner or Physician Assistant?

Yes, there will be a charge as they have provided a service. 

Our nurse practitioners are advanced registered nurses who are educated and trained to provide health promotion and maintenance through the diagnosis and treatment of acute illness and chronic conditions. According to the International Council of Nurses, an advanced practice registered nurse is “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A master’s degree is recommended for entry-level.” (Wikipedia)

Our physician assistants or physician associates are healthcare professionals who practice medicine as a part of a healthcare team with supervising physicians and other providers. In the United States, PAs are nationally certified and state-licensed to practice medicine. A certified PA may add “C” at the end of his/her postnominal credentials. PAs are trained with the medical model and complete these qualifications in less time than a traditional medical degree. (Wikipedia)

Do you take Medicaid?

We currently take Colorado Medicaid for patients who are living in Larimer County on a limited basis.

Do you take out-of-state Medicaid?

We are not currently taking out-of-state Medicaid.

Why do I have to have records or referrals from another provider sent prior to my office visit?

This allows our providers to review your records and recommend the best course of treatment.

If I am established with a doctor at Center for Gastroenterology, why do I have to ask to transfer care from one doctor to another?

It is the practice of Centers for Gastroenterology to review the transfer of care. This allows the providers to evaluate the request and make a recommendation to ensure that the best care is provided for our patients.

Are Centers for Gastroenterology affiliated with Banner or UCH?

Centers for Gastroenterology is independently owned. We do have a close relationship with both Banner and UCH.

How can I opt out of E-statements?

You may contact one of our Financial Representatives at 970-207-9773 and they will help you to opt-out.

Do I have to pay upfront to schedule my procedure?

Centers for Gastroenterology do not currently require an upfront deposit before the procedure.  

Please check with the facility you are scheduled at to determine if they will require a deposit upfront.

• Harmony Surgical Center – 970-297-6366 https://harmonyasc.com/
• Skyline Endoscopy Center – 970-663-2159 http://www.skylineendocenter.com/
• Estes Park Medical Center – 970-577-4678 https://www.epmedcenter.com/
• Poudre Valley Hospital – 970-495-7254 Estimate Line 970-495-7222
• Medical Center of the Rockies – 970-624-2500
• McKee Medical Center – 970-669-4640
• Greeley Surgical Center – 970-624-2500

I received an Advanced Medical Beneficiary (ABN) regarding my procedure that indicates that my Medicare or my Medicare replacement may not cover the cost. Why did I receive this?

Medicare and Medicare replacement plans require that specific criteria be met for procedures. We have checked the criteria and it does not meet the listed criteria. The form is to advise you of this information along with an estimate of the cost for our office so that you may decide if you would like to continue with the procedure. If you would like to continue with the procedure please fill out the information and return it to us by mail, email or bring it with you to the procedure. If you indicated you would like to have the procedure and have us bill your insurance, we will send a claim to Medicare or your Medicare replacement. If they do not pay you will be responsible for the balance. Please be aware that most supplements will not pay when Medicare or a replacement plan denies the claim.

Does Centers for Gastroenterology accept CICP?

We are not part of the CICP program.  We do offer a 25% discount for our self-pay patients. 

Does Centers for Gastroenterology accept Care Credit?

We do not accept Care Credit.