High-quality care.
Financial Policy
Effective 7.30.2015
Our goal is to provide excellent medical care in a comfortable, personal, and cost-effective manner. Our financial policies have been developed to help lower the cost of medical care for our patients. You can help by paying for your care in a timely manner.
Patient Payment Responsibility
Payments to Gastroenterology Specialists, Inc. may be made by cash, check, Visa, MasterCard, Discover, or American Express. Patients are required to provide GSI with correct insurance information and are responsible for all charges incurred as a result of incorrect and/or insufficient information provided.
Patients are expected to pay any copays and/or deductibles at the time of each visit. Patients with no insurance are expected to pay in full at the time of each visit. GSI strives to include all charges at the time of service, but occasionally, charges may be added or modified after the visit. (For example: an additional blood or urine tests may be ordered or the level of service provided during a consultation may be modified per American Medical Association guidelines). GSI will bill all insurance claims as a courtesy to patients, but the patient, NOT the insurance provider, is responsible for the payment of all services. Patients who disagrees with any charges must contact this office in writing within thirty (30) days of the billing date. A refund will be issued if GSI receives an insurance payment for a charge already paid by a patient. GSI will gladly resubmit a corrected claim if an error was made on the original claim.
Gastroenterology Specialists, Inc. reserves the right to charge a fee for delinquent accounts and for submitting insurance forms after sixty (60) days. If ongoing medical care is needed, patients are expected to make payments on old balances as well as payment in full for new charges at the time of service. Accounts with balances over ninety (90) days may be transferred to a collection agency.
No Show and Cancelled Appointments
Gastroenterology Specialists, Inc. reserves the right to charge a fee for “no show” and “cancelled” appointments with less than a 24 hour notice. Our policy requires: (1) receiving a 24-hour notice if the patient is unable to keep an appointment; (2) applying a fee for missed or cancelled appointments with less than a 24-hour notice; and, (3) discharging a patient when two appointments are missed or three appointments are cancelled without sufficient notice. New patients failing to keep their first appointment without a 24-hour notice may not be granted another opportunity for an appointment.
Office appointments cancelled with less than 24 hours’ notice:
1st time: Warning – no charge
2nd time: $50.00 charge
3rd time: Potential discharge from clinic
No Show Office Appointments:
1st time: Warning and/or $50.00 charge
2nd time: Potential discharge from clinic
PROCEDURES CANCELLED WITH LESS THAN 72 HOURS’ NOTICE WILL INCUR A CHARGE OF $100.00
Authorization to Release Information
By signing that you have been given this Financial Policy, you authorize Gastroenterology Specialists, Inc. to release medical information acquired in the course of examination and treatment for the purpose of filing for insurance benefits and other financial coverage. Disclosed information may include your mental health, alcohol or drug abuse treatment, HIV, other communicable diseases, and developmental disabilities, as well as genetic information. This authorization to release information shall remain in place until all claims have been paid.