3409 Worth Street Suite 600 Dallas, Texas 75246 | 214.824.1730
www.northtexascolonandrectal.com

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Billing and Insurance

Quick links:

NTCR Payment Policy
Patient Forms - Colonoscopy
Managed Care and Commercial Insurance Plans
Medicare/Medicaid Policy

For service you must authorize payment directly to North Texas Colon and Rectal for the medical and/or surgical benefits otherwise payable to you. You also must understand that you will be financially responsible for the charges not covered by your insurance.

NTCR Payment Policy

A billing representative will call your insurance for prior approval and will verify your insurance benefits. Should a deductible be applied we require payment prior to any service or procedure.We will bill you for the co-insurance after the insurance processes your claim. For charges less than $200.00 and not covered by insurance. PAYMENT IN FULL is requested at the time of service. Charges that exceed $200.00 and that are not covered by insurance should be addressed with our account representative.

Procedures done inside and outside our office will generally fall under your deductible, co-pay and co-insurance carrier. Should you have any questions regarding the payment policy, your charges or responsibilities, please contact us at 214.824.1730 option #4. We will be a happy to assist you.

Clear understanding of the costs of the services provided OUTSIDE our office is imperative. Our Patient Representative can provide you with "an estimate" of the facilities fee based on your scheduled procedure. Be advised that on occasion, your original procedure may change or an additional procedure may be added. Please understand what is included in your facility fee and what is not.

Your facility fee includes the following:

Procedure room
Recovery room
Medical equipment
Medications and supplies*

*In unusual circumstances where certain prosthesis or unusual instruments are used this may generate additional cost. This is an extremely unusual event. If your physician anticipates using such device you will be notified. Also in rare occasions the patient may require a different or an additional procedure done, unfortunately these events are determined at the time of surgery and are somewhat unpredictable. This could generate additional cost, fortunately this is uncommon.

The facility fee does not include:

Physician Fees
Anesthesia Services (Physician/CRNA)
Laboratory testing
Pathology
X Rays

North Texas Colon and Rectal PA, accepts various methods of payment for the convenience of our patients. Payment options include cash, check, money order, Master card and Visa.

Advanced Payment VIA Internet - The costs of mailing monthly statements is a very expensive process. Our physicians and staff are committed to doing everything possible to keep health care costs from rising; therefore, we ask that our patients assist us in keeping costs to a minimum. This service will soon be available.

Any patient who has filed bankruptcy will be seen on a cash basis only.

If your personal check is returned to our office for any reason, the amount of the check will be reinstated to your existing balance and a $25.00 service charge will be assessed to your account. Patients will be informed of the returned check and asked to handle these amounts immediately in the form of cash and or money order.

In certain instances, we might receive payment from your insurance company for a previously paid service. Should that happen, the overpayment will be refunded to you. Please extend the same courtesy to us if you receive payment for outstanding charges. Keeping insurance money is dishonest. Failure to forward this money to our office may result in a patient being dismissed from the practice.

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Patient Forms - Colonoscopy

Click here to download the Advance Beneficiary Notice for Colonoscopy PDF.

Managed Care and Commercial Insurance Plans

North Texas Colon and Rectal PA, participates in a number of managed care plans; however, please be aware that there may be different reimbursement schedules for in and out of network providers. If you are unsure if we participate in your particular plan, please be sure and check with us before scheduling an appointment.

As a courtesy to you, we will file your primary insurance; however, it is essential that we receive accurate and timely information. Our office will be happy to re-file insurance one (1) additional time if we do not receive a response within 45 days. After a 60 day period, it will become your responsibility to follow up with your carrier to determine why the claim has not been paid. Regarding secondary insurance coverage, our office will be happy to submit a claim for you.

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Medicare/Medicaid Policy

Medicare

Our office accepts assignment on Medicare. What this means is that we have agreed to accept Medicare's allowed amount as payment however, Medicare only pays 80% of the approved amount leaving a 20% co-payment on the approved charges. The 20% is the responsibility of the patient.

In addition, patients will be responsible for the Medicare deductible if it has not been met. Unless there is a secondary insurance to file and cover that.

Medicaid

We do accept Medicaid patients by physician referral only. Medicaid patients will be responsible for bringing a signed, valid card with them to all office visits. Co-payment is expected in full at each visit.

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