Digestive Disease Center (845) 452-9800
 
 
 

Insurance

Here at Digestive Disease Center, we proudly participate with most insurance plans, including the following:

  • Aetna
  • Aetna Golden Medicare Choide PPO
  • Aetna Golden Medicare HMO
  • Beechstreet
  • Blue Cross & Blue Shield
  • Blue Cross & Blue Shield Medicare Advantage
  • CDPHP
  • CIGNA HMO
  • CIGNA PPO
  • Emblem
  • Empire Plan
  • Fidelis Care
  • GHI HMO
  • GHI Medicaid, FHP, CHP
  • GHI Medicare
  • GHI PPO
  • Healthnet
  • Healthnet Medicare Smartchoice
  • Healthnow
  • HealthQuest
  • Hudson Health Plan
  • Humana
  • Local 1199
  • Local 825
  • Maxon
  • Medicaid
  • Medicare
  • Multiplan
  • MVP
  • MVP Medicaid
  • MVP Medicare Choice
  • Nova Healthcare
  • Oxford
  • Pomco
  • Railroad Medicare
  • United Healthcare
  • Wellcare Medicaid
  • Wellcare Medicare

It is our goal to provide every patient with the highest standard of health care. Each of our physicians is committed to providing this level of care in order to maintain the integrity of their practice, while recognizing that services should be limited by necessity. Our billing specialists will file insurance claims for services rendered on your behalf. However, it is your responsibility to contact your insurance company prior to services for specific policy, coverage limitation, coinsurance, deductible and copayment information. It is most importance that you provide our front desk staff with your most recently updated insurance information, as providing this information and payment for services rendered is the obligation of the patient. Our practice participates with Medicare as well as numerous commercial insurances, which include HMO’s, PPO’s and other private payers. When a practice agrees to participate with an insurance company, this means it accepts the insurance company’s allowed amount for services rendered. However, any portion of the reimbursement in which your insurance company determines to be your responsibility due to deductible, coinsurance, copayment amount or coverage issues becomes your obligation to the practice. Our billing specialists are available Monday – Friday from 8a.m. to 4:30p.m. for any assistance you may need regarding your bill. The direct billing office phone number is (845) 231- 5380.

Practice Fees

Our practice fees are determined by the amount of time required by the physician to thoroughly and effectively assess and care for each patient according to their individual health care needs. This includes suggestion and review of diagnostic testing as well as counseling for each patient’s individual health care management. This includes diet and exercise regimens, proper use of supplements and any prescription medication management deemed necessary by the physician. We keep our fees within what is considered reasonable within our geographic area. Please contact our billing office at (845) 231-5380  for any questions regarding fees for prior or upcoming services. They will be happy to assist you!

Facility Fee

For all services performed at Hudson Valley Endoscopy Center or any other out-patient facility, a claim will be filed, which represents charges that are completely separate from that of the  physician who performed your service. The claim that the physician bills to your insurance company represents only the charges for him/her to perform your service. The claim generated by the facility to your insurance company reflects charges for the use of equipment, medical supplies and the time the nursing staff spent with you before, during and after your procedure. These facility charges are approved by all major insurances companies. If your insurance company determines that a co-payment, coinsurance or deductible be applied to your facility claim, you will receive a separate statement from the facility. If your insurance company also renders a portion of the physician’s claim your responsibility, then you will receive two separate statements, one from the physician’s office and one from the facility.

In the event that, during your procedure, biopsies and/or removal of specimens are performed, they will be sent to the pathology group for analysis. The pathology group is a separate entity from The Digestive Disease Center and the out-patient facility and, therefore, will also submit its own claim to your insurance company. Any coinsurance, deductible or co-payment rendered your responsibility for your pathology claim will be billed to you by the pathology group to which the specimens were sent.

The anesthesiologist or certified nurse anesthetist who assists with your procedure is also a separate entity from The Digestive Disease Center and the out-patient facility. They will also submit their own claim to your insurance company as there is a separate fee for administration of anesthesia. Like the others, any coinsurance, co-payment or deductible rendered your responsibility by your insurance company for your anesthesiologist’s claims will be billed to you directly from the anesthesiology group.

Monthly Statements

Monthly statements will be sent to you which will reflect the charges sent to your insurance company, the amount of reimbursement received from your insurance company and the amount (if any) your insurance company rendered as patient responsibility. In the event that your insurance company reimburses your claims in full, leaving no patient responsibility, you will not receive any statements.

We ask that you be aware of any co-payments, which are standard for your insurance plan, prior to your service and be prepared to pay our receptionist at the time of your service. The cost of sending statements and other additional paperwork contributes greatly to these expenses. Reducing any excess and unnecessary paperwork allows us to keep our charges as low as possible. If you are suffering a financial hardship, please contact our billing specialists, who will be glad to make special payment arrangements for you. It is our hope that you will find them to be understanding and professional.