Insurance, Billing, and Financial Policies
We are deeply committed to providing accessible healthcare services for the Austin community. We believe that exceptional care should be within reach for everyone, which is why transparency is at the core of our financial policies, accepted insurance plans, and billing practices.
Our team works diligently to ensure patients fully understand their options and feel supported throughout their healthcare journey. By fostering open communication and patient-centered care, we aim to make managing digestive health as straightforward and stress-free as possible for all those we serve.
Working with Your Insurance Plan
We work with patients and insurance carriers to make sure that you receive the care you need. We participate in most major insurance plans. We also accept private-pay (or self-pay) patients. Before your first visit to Austin Gastroenterology, please see our Financial Policy.
Insurance
At Austin Gastroenterology, we currently accept the following insurance coverage:
- AARP/WellMed
- AARP/United Healthcare
- Aetna
- Amerigroup Wellpoint/Medicare/Medicaid-WellMed
- Amerivantage Medicare
- BCBS Par Plan
- BCBS PPO
- BCBS HMO Blue
- BeechStreet/Capp Care
- Blue Choice
- TX HMO Blue Essentials, Essentials Access, Premier & Premier Access
- HealthSelect
- Indemnity
- Par Plan
- Medicare Advantage PPO/POS/HMO
- Care Improvement Plus - Medicare (UHC)
- Champus (TriCare)
- ChampVA
- Cigna
- Connected Senior Care Advantage
- Coventry Healthcare/National
- Devoted Medicare Advantage
- First Health
- Galaxy Health Network
- Health Payors
- Healthcare Highways
- HealthSmart
- Humana ChoiceCare
- Humana PPO
- Humana HMO
- Integrated Medical Systems
- Kaiser Permanente Ins Comp (KPIC) PHCS Only
- Mulitplan-Network
- PHCS
- Seton Health Plan
- Texas True Choice
- TriCare
- UMR--UHC Choice Plus Network
- United HealthCare Choice Plus/Options PPO
- Baylor Scott and White UHC
- Golden Rule/United Healthcare One/UHC Shared Services
- UnitedHealthcare
- Traditional Medicare
- Traditional Medicaid
- USA Managed Care Organization
- WellMed/AARP (UHC)/Humana/Wellpoint Amerigroup
Please Note: You will be asked to pay your anticipated responsibility once your procedure has been scheduled. As a courtesy to our patients, we will file claims on all visits and procedures performed by Austin Gastro providers at our offices, endoscopy centers, or hospitals.
When we file a claim on your behalf, it is with the understanding that your insurance company will pay Austin Gastroenterology directly. You are responsible for payment of all co-pays, deductibles, co-insurance, and non-covered services.
After a service has been provided, we will bill your insurance carrier. Your insurance carrier will review the bill and, in most cases, pay their portion within 90 days.
Referral Authorizations
For some insurance carriers—HMOs in particular—Austin Gastroenterology requires a written authorization from your insurance company. Usually, this can be provided by your primary care physician.
It is the patient's responsibility to know whether your insurance requires a referral authorization. If a referral authorization is required, you should obtain it before you are scheduled to see our physicians. If you do not have a current authorization on file, we will be happy to see you; however, you will be responsible for payment in full at the time of service.
Our office will be happy to assist you in determining the status of any one of our doctors on your insurance plan; however, this does not guarantee coverage. You should take the time to call your insurance company to ask specifically about the doctor you wish to see and your covered benefits.
Referral authorizations typically have an expiration date and a limited number of visits. You should be careful to monitor the dates and visits.
Private Pay
Patients who do not have insurance are expected to pay for all the services performed. We will request payment for outpatient procedures in advance of having the procedure performed.
We understand that individual situations may make it difficult to meet these financial expectations and are happy to discuss other payment arrangements, as needed.
Understanding Your Bill
We understand that medical bills can be complex. At Austin Gastroenterology, we believe an informed patient is a happier, more satisfied patient. We have put together some general information about understanding your Austin Gastro bills, as well as frequently used terms in medical billing.
Pay Your Bill Online
View your account information and make payments using our convenient online portal. You may log in to the patient portal using the link below to safely and securely make Austin Gastro bill payments online.
Billing Basics
We routinely file all necessary claims to insurance companies for reimbursement. The patient, however, is ultimately responsible for payment of the bill. It is extremely important that Austin Gastroenterology and the Austin Endoscopy Center be given all the information regarding the patient's insurance as soon as possible, so that we can verify that insurance is current and determine the nature of coverage. Please be advised that there are instances when a health plan's database may not reflect current information.
Most insurance plans do not cover 100 percent of your visit. You may be expected to pay a facility fee, co-insurance, or co-pay (depending on your insurance) prior to your office visit and/or procedure.
Payment of co-insurance, co-pays, and deductibles may be made with cash, check, or credit card, including Master Card, Visa, American Express, or Discover.
Terms Listed on Your Bill
Let's look at some terms you may find on an Austin Gastroenterology bill. Note that some terms and codes are specific to your insurance carrier and will not be featured here.
Statement Date: The date that the bill was created. Unless otherwise stated, Austin Gastro asks that you pay your bill upon receipt.
Chart Number: A unique code that Austin Gastroenterology uses to refer to you. Your chart number will be used throughout your visits to our offices.
Services Listed: The services performed, listed by code. Your statement of account will include only those services rendered to you by Austin Gastro and/or Austin Endoscopy Center.
Services provided by your (non-AG) doctor/anesthesiologist, pathologist, laboratory and/or hospital will be billed by their respective offices.
Note that if you've had a procedure done, you may receive two separate bills: one from Austin Gastroenterology for your office visit and another from Austin Endoscopy Center for the procedure.
Procedure*: The code for your procedure. Common procedure codes include:
- 43235-43239: Upper Endoscopy
- 43260-43265: ERCP
- 45330-45335: Flexible Sigmoidoscopy
- 45378-45388: Colonoscopy
- 83013-83015: Urea and Hydrogen Breath Tests
- 91110: Capsule Endoscopy
- 99201-99205: New Patient Consultation
- 99211-99215: Established Patient Consultation
- 99241-99245: General Consultation
- J1745: Infusion Services
*Please note: This is not intended to be an exhaustive list of all the services Austin Gastroenterology and Austin Endoscopy Center provide.
Primary: Your insurance provider.
Guarantor: You, the patient.
Adjustment: Billing adjustment will be based on Austin Gastro and Austin Endoscopy Center's contractual agreements with the patient's particular health plan.
Remainder: The amount left to be paid by the guarantor.
Top Gastroenterology Clinic in Austin, TX
At Austin Gastroenterology, you don’t have to be confused about whether your services are covered by insurance or how to pay your bill. We offer you the tools and resources you need to get your GI care with confidence.
Still have questions for us? Visit our FAQs page for more information. To speak directly with one of our staff members about your concerns, call our office nearest you today. To schedule an appointment with one of our skilled providers, you can send us a message on Klara or fill out our secure online appointment request form. We look forward to being your partner in your journey to better health.
