Billing Information

Financial Policy

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Billing & Patient Responsibilities

At Integrated Gastroenterology Consultants, we are committed to providing you with the highest quality care and ensuring a smooth and efficient healthcare experience. To facilitate this, we ask our patients to take an active role in their healthcare journey by fulfilling the following responsibilities:

  • Obtaining a Referral: Some insurance plans require a referral from a primary care physician before you can see a specialist or undergo certain procedures. It is the patient's responsibility to obtain any necessary referrals prior to scheduling an appointment with us. Be sure to check with your primary care provider and confirm that the referral is on file before your visit. Not all insurance plans require referrals, but certain types, such as Health Maintenance Organizations (HMOs) or Point of Service plans (POS), may have this requirement. It is advisable to check your insurance policy or contact your insurance provider to determine whether a referral is needed for your specific plan. If you need a referral, we will do our best to obtain it, but it is ultimately your responsibility to be sure one is inplace for your date of service. Without a required proper referral, all the costs associated with the visit will be the patient's financial responsibility.

  • Maintaining Active Insurance: Ensure that your insurance coverage is active and up-to-date. Different insurance plans may have varying requirements, and it is crucial to be aware of your coverage details, including any co-pays or deductibles. If there are changes to your insurance information, please inform our staff at the earliest convenience. Coordination of benefits refers to the process of determining which insurance plan will pay for medical expenses when an individual is covered by more than one insurance policy. If you have multiple insurance plans, it is important to provide accurate information about each plan to ensure proper coordination and billing.

  • Punctuality: Time is valuable, and arriving promptly for your scheduled appointments helps us maintain an efficient schedule for the benefit of all our patients. Please make every effort to arrive at least 15 minutes before the start of your appointments, allowing for necessary paperwork and check-in procedures. Failure to not arrive on time (10 minutes or later) may require your appointment to be rescheduled.

  • No Shows or Late Cancellations: We understand that circumstances may arise, and plans may need to be adjusted. However, we kindly request that you notify us of any cancellations at least 72 hours before your scheduled appointment - we have many patients who need an appointment, and giving us advanced notice allows us to fit in other patients. If you no-show or cancel your appointment less than 72 hours prior, you may be charged a no show fee of $75 per clinic visit and $150 per procedure (for commercial insurance or Medicare) or a $50 rescheduling fee (for Medicaid/Masshealth). This is to cover the cost of the staff, space, and time we have reserved specifically for you.

Failure to fulfill these responsibilities may lead to financial consequences and/or dismissal from this practice.

At Integrated Gastroenterology Consultants, we appreciate your cooperation in meeting these responsibilities, as it allows us to provide you with the best possible care and service. If you have any questions or concerns about your responsibilities or our policies, please do not hesitate to contact our office.

Patients may expect bills from the following entities based on two services, office visits or procedures:

Office visits 

If you had an office or clinic visit,  you may expect a bill from Integrated Gastroenterology Consultants. Payments are made using the Patient Portal by credit card. Cash or check payments may be made at our main office at 41 Wellman St, Suite #400, Lowell, MA 01851.

Procedures 

If you had an out-of-office procedure performed at a hospital or endoscopy center (such as a colonoscopy, upper endoscopy, esophageal manometry, etc.) you may receive up to four bills for the following:

Physician fee from Integrated Gastroenterology. 

Pathology fee from Integrated Gastroenterology. 

Facility fees are billed from the location where the procedure was performed. For billing inquiries, please contact the location where the procedure was performed:

Anesthesiology fees are billed from the facility where the procedure was performed.

Screening versus Diagnostic Colonoscopies

Screening colonoscopies and diagnostic colonoscopies are performed similarly using the same equipment. The difference is how the procedure is billed to your insurance. Billing will depend on your symptoms (or lack of symptoms) and what your doctor finds during the procedure. A colonoscopy is considered preventive screening if the patient doesn’t have any gastrointestinal symptoms and no polyps or masses are found during the colonoscopy.

The Affordable Care Act (ACA) considers preventive services “essential health benefits” and requires insurance companies to pay all associated costs. That also means you won’t have to pay a copay or coinsurance for a screening colonoscopy. Since a diagnostic colonoscopy isn’t considered preventive, your insurance may require you to pay a copay or coinsurance.

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