Office Polices
All co-payments and past due balances are due at the time of service. In addition, we may collect a portion of your deductible if it has not yet been met. We accept cash, check or credit cards. We will bill your insurance for covered procedures. Once they have paid, you will receive a bill for any remaining deductible or co-insurance amounts owed. The balance is due in full within 30 days of receipt of the statement. Failure to do so may result in further collection activity which may include referral to an outside collection agency and/or inability to schedule any further appointments. If you are unable to pay the full amount within 30 days, please speak to the office
There will be a $25 fee assessed on returned checks.
Medical Records and Medical Forms
Should you need a copy of your medical records, please fill out our medical records release form to authorize the release of records and designate a recipient. Charges to complete medical forms (driver's license, assisted living, insurance, etc and patient-requested letters are not covered by insurance and are therefore the responsibility of the patient. Fees vary according to the length and complexity of the records requested, patient form or patient-requested letter and are determined by management
Any after-hours calls the patient requests the answering service places to the physician on call that is not deemed a true emergency by the physician may result in a $50 charge to you. This charge will not be covered by insurance and will be patient responsibility.
Missed Appointments/Cancellations
Office Visits: Our office policy is to require at least 24 hour's notice of cancellation of a booked appointment. Failure to provide adequate notice may result in a missed appointment fee from your physician. (Missed new patient appointment: $75. All other visits: $50)
Procedures: We would like you to be aware that the scheduling process for an endoscopy/colonoscopy procedure involves coordinating the schedules of your physician, the procedure room, and the necessary staff. Due to the high demand for endoscopy procedures, the procedure room is typically booked one month in advance. In the absence of adequate notice, cancellations result in a waste of key resources as it is often not possible to schedule another case in the same time slot without adequate notice. This policy stipulates (apart from exceptional circumstances) that if you cancel/reschedule your procedure with less than 5 business day notice or fail to keep your appointment, you will be charged a $200.00 fee. If you cancel your procedure with more than five business day notice no charge will be made.
I hereby assign all medical and surgical benefits to which I am entitled. I hereby authorize and direct my insurance to issue payment directly to EGI for medical services to myself and/or my dependents.