Associates in Digestive Health

WHAT TO EXPECT FOR YOUR COLONOSCOPY:

Please read and follow these instructions carefully so the examination will be successful. The day prior to the procedure, you will need to prep which will cause diarrhea. If you do not have liquid stools after taking this prep, notify the office before coming in for your colonoscopy. You must have a responsible adult who is known to you drive you home - this cannot be a taxi, Uber, or bus unless there is a known responsible adult to accompany you. The sedation can cause amnesia so this person may need to witness some or all of the post-procedure discussion to be able to provide directions to you when you return home. You will be able to resume normal activities the day after the procedure unless otherwise instructed. No driving for 24 hours post-procedure.

Please read the Pre-Procedure Instructions for important information regarding your colonoscopy preparation, including pre-procedure medication information.

Sign up or access the Patient Portal for quick access to results of procedures, appointment times, and to communicate with your care team.

Colonoscopy utilizes a long flexible tube camera to evaluate the large intestine. This test is commonly performed to investigate the cause of blood in the stool, diarrhea, abdominal pain, a change in bowel habits, or personal/family history of polyps/cancer.

An intravenous (IV) will be started in your arm and you will be sedated to make you drowsy and relaxed. The examination is performed with you lying on your left side and the colonoscope will be gently guided through the colon. If any abnormalities are found, such as polyps, biopsies (removal of small pieces of tissue) may be taken for examination. This is a very safe procedure and in many cases eliminates the need for surgery.

Your stay at the facility will be approximately two hours long, depending on how long it takes to pass the scope around the colon.

AFTER THE PROCEDURE:

You will be observed for about thirty minutes before going home. You will not be allowed to drive for 24 hours after the procedure since you will be drowsy for several hours afterward. Following the procedure, your doctor will inform you of the preliminary results of the test. A follow-up visit may be scheduled so the final test results (biopsies) can be explained to you when you are fully awake.

RISKS:

This is a very safe examination, but there is a small risk of complications, which occur in less than 1% of patients and may include bleeding or perforation of the bowel. Reactions to medications, such as allergic reactions or difficulty breathing occur rarely. If you experience severe pain, bleeding, or any serious problems after the test, please contact our office immediately at (239) 772-ENDO (3636).

ABOUT YOUR BILL

We are pleased that you have chosen us to provide your medical care. It is our desire to provide you with the highest quality medical care possible. Therefore, we would like to make you aware of the following information.

IF YOU HAVE HEALTH INSURANCE we will file all claims on your behalf. We will request that payment from your insurance company be sent directly to our office. It is your responsibility to know and understand the benefits provided by your insurance coverage for the procedures that are to be performed.

A statement will be mailed to you if there is an additional amount due from you after your insurance company has processed your claim. If your prepaid amount results in a credit balance, you will receive a timely refund from us.

IF YOU DO NOT HAVE HEALTH INSURANCE a deposit of 50% of the estimated charges will be collected from you. This amount is due no less than two days prior to your scheduled appointment. Please remit this payment to avoid any delays in your procedure. Payment of the balance is due 14 days after your procedure. If you need to make special arrangements for payment of your procedure, you must call our billing office at 239-772-3636 option 5.

You can expect to see insurance claims and/or bills from the following parties:

Associates in Digestive Health Billing Office 239-772-3636 option 5

This bill is for the physician's fees for performing the procedure.

Cape Health Surgery Center / Fort Myers Surgery Center Billing Office 239-772-3636 option 5

This bill is for the facility where your procedure was performed. It includes the operating room, nursing services, supplies, and equipment used during your procedure.

CRH Anesthesia of Cape Coral/IPS Billing Office 239-205-7709

This bill is for the Certified Registered Nurse Anesthetist's (CRNA) services rendered during your procedure at the Cape Health Surgery Center.

Laboratory You will receive a bill from a laboratory if biopsies or polyps are taken during your procedure. Various laboratories are used, depending upon your individual insurance coverage. A telephone number for billing inquiries will be included on any bill you receive from the laboratory. Some laboratory charges are split between two parties. A bill may be received from the laboratory for the physician's review of the specimen and a bill may be received from Associates in Digestive Health for the technical services which include preparation of the specimen on the slides. This is not a duplicate billing.

Colonoscopy Insurance Benefits Information

There are two types of colonoscopies:

1. Diagnostic (also known as medical)

2. Screening (also known as preventative or routine) (Screenings are also classified as average or high risk)

Diagnostic

A diagnostic colonoscopy is performed for a patient with symptoms. (Examples: constipation, diarrhea, weight loss, abdominal pain, rectal bleeding, anemia, history of colon polyps or cancer)

Screenings

Average risk screening – A patient that is at least 50 years old and has no past or current bowel symptoms and no risk factors.

High risk or surveillance screening – A patient with risk factors or personal history of colon polyps and/or colon cancer, a family history of colon polyps and/or colon cancer and certain inflammatory bowel diseases. The age of the patient would not apply. Due to your risk factor, your physician will recommend you have these more frequently.

How does my insurance cover my colonoscopy?

A diagnostic or medical colonoscopy is generally subject to one’s major medical benefits, deductibles, co-insurance and/or co-pays). These are performed as an outpatient procedure so checking your benefits for “outpatient surgery” will give you a better idea of what type of out-of-pocket expenses you may incur.

An average risk screening is generally covered by one’s wellness benefits. Most (not all) insurance companies will cover this at 100%, once every ten years and the patient must be over the age of 50. However, if during your screening colonoscopy a diagnosis is made, an additional procedure is performed and/or biopsy or specimen is collected, you may be responsible for out of-pocket costs as a “diagnostic/medical colonoscopy”.

A high risk or surveillance screening coverage is specific to your insurance company. Some insurance companies will cover these under wellness benefits and some will cover these under major medical benefits. Insurance companies DO NOT have to cover these at 100%.

**This is only a general guideline of insurance coverage for your colonoscopy benefits. Each insurance company will vary their coverage and costs.