Iowa Digestive Disease Center is dedicated to providing the best care and compassionate service to our patients. This page should help patients get information they need from their insurance provider before receiving health care services.
We accept all major insurance plans and it is important that you have a good understanding on your insurance plan coverage and what, if any, financial responsibilities you may have from medical care that you receive from us. Because insurance plans vary widely, we strongly recommend and encourage you to speak with your insurance company. As it is not possible for IDDC/IEC to know all the details of different insurance plans, you need to know your insurance coverage before your appointment is scheduled for an office visit or a procedure.
As screening colonoscopies are provided on an outpatient basis, please check with your insurance provider if it will be covered in this setting. Iowa Endoscopy Center is considered an Ambulatory Surgical Center.
Speaking directly to your insurance provider is the best way to avoid any misunderstanding about your benefits.
Many health insurance plans offer a screening colonscopy as a health benefit for patients age 50 and older with most or all of the cost paid by insurance plan. Please check with your provider if this benefit is available to you.
Questions to ask your heath insurance provider:
- How much does my insurance pay for screening colonoscopy?
- How much does my insurance pay for diagnostic colonoscopy?
- How much does my insurance pay for EGD (Esophagogastroduodenoscopy)?
- Is the doctor/facility performing the exam within my health insurance network?
- How will the procedure affect my out of pocket expense if it started as a routine screening and polyps are taken?
- How much of my deductible/co-insurance have I satisfied this year?
How do insurance companies decide what they will pay for and how much?
Insuranace companies set limits on what tests they will pay for and what tests they will only pay a portion of the cost. It is the patient’s responsibility to make sure they understand the benefits their health insurance plan provides. Health plan benefits are also subjected to deductibles and co-insurance.
You will receive two statements – One from Iowa Digestive Disease Center (physician charges) and one from Iowa Endoscopy Center (facility charges).
If you have a procedure at a hospital, you will receive a separate statement from that facility. If any biopsies are taken, you may also receive a statement from the pathology lab and/or provider.
As defined by Medicare, a screening colonoscopy is a test performed on a patient who does not have any prior signs or symptoms, age 50 and older and a patient who has never had a colonoscopy.
If you were referred to our clinic with symptoms such as change in bowl habits, diarrhea, constipation, anemia or rectal bleeding, the colonoscopy would be considered diagnostic.
If you have had colonoscopy in the past and polyps were found, any subsequent colonoscopy(surveillance) would be considered diagnostic and would apply to deductibles and/or co-insurance.
EGD procedures are not considered screening and will always be diagnostic resulting in charges being applied to deductibles and/or co-insurance.
Surveillance procedures are needed to see how diseases on colon or esophagus are progressing with or without treatment. Colon polyps can recur and a repeat colonoscopy may be necessary.
Please contact our billing office at 515-288-6097 if you have further questions.