{"id":954,"date":"2023-02-10T17:45:33","date_gmt":"2023-02-10T17:45:33","guid":{"rendered":"https:\/\/gastrodr.com\/?page_id=954"},"modified":"2024-09-12T21:26:10","modified_gmt":"2024-09-12T21:26:10","slug":"understanding-insurance","status":"publish","type":"page","link":"https:\/\/gastrodr.com\/index.php\/understanding-insurance\/","title":{"rendered":"Understanding Insurance"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div class=\"x-section e954-e1 mqi-0 mqi-1 mqi-2\"><div class=\"x-bg\" aria-hidden=\"true\"><div class=\"x-bg-layer-lower-image\"><\/div><div class=\"x-bg-layer-upper-color\"><\/div><\/div><div class=\"x-container max width e954-e2 mqi-4\"><div class=\"x-column x-sm x-1-1 e954-e3 mqi-5\"><div class=\"x-text x-text-headline e954-e4 mqi-6\"><div class=\"x-text-content\"><div class=\"x-text-content-text\"><h1 class=\"x-text-content-text-primary\">Understanding Insurance<\/h1>\n<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"x-section e954-e5 mqi-0 mqi-3\"><div class=\"x-container max width e954-e6 mqi-4\"><div class=\"x-column x-sm x-1-1 e954-e7 mqi-5\"><div id=\"\" class=\"x-text\" style=\"\" ><p style=\"margin-bottom: 20px;\">\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<strong><span style=\"color: #00535C;\">Health insurance<\/span><\/strong> can be complex due to the various factors that contribute to its cost, coverage options, regulations, and provider networks. These factors can make it difficult for individuals to understand their options and make informed decisions about their coverage. This could lead to unexpected costs and financial burden if you need medical care that is not covered. We have compiled some information that may be helpful when reaching out to insurance about your coverage. GI Partners of IL does <strong><span style=\"color: #416c99;\">not<\/span><\/strong> check insurance coverage. We recommend patients to call their insurance to verify coverage. Write down the name of insurance representative, the date you called, and reference #. \u00a0Listed below are common questions to ask insurance.<\/p>\n<p>Please click <a href=\"http:\/\/gastrodr.com\/wp-content\/uploads\/2023\/02\/Understand-insurance.pdf\"><strong><u><em>Here<\/em><\/u><\/strong><\/a>\u00a0for more details.<\/p>\n<hr \/>\n<\/div><\/div><\/div><\/div><div class=\"x-section e954-e9 mqi-0 mqi-1\"><div class=\"x-container max width e954-e10 mqi-4\"><div class=\"x-column x-sm x-1-1 e954-e11 mqi-5\"><div id=\"\" class=\"x-text\" style=\"\" ><h2 style=\"text-align: center;\"><strong>\u00a0 \u00a0 \u00a0\u00a0<\/strong><span style=\"color: #ea593e;\"><strong style=\"text-align: center;\">Questions Patients Can Ask The Insurance Company<\/strong><\/span><\/h2>\n<p><\/br><\/p>\n<ul style=\"text-align: left;\">\n<li><strong>Is my procedure a covered benefit?<\/strong><\/li>\n<li><strong>What is my responsibility for this procedure? Deductible, Max out-of-pocket?<\/strong><\/li>\n<li><strong>What if I have a screening colonoscopy and a polyp is removed? Will I owe anything?<\/strong><\/li>\n<li><strong>Is anesthesia covered under my plan?<\/strong><\/li>\n<li><strong>Is the anesthesia provider in my network?<\/strong><\/li>\n<li><strong>What if anesthesia provider is out-of-network?<\/strong><\/li>\n<\/ul>\n<p><\/br><\/p>\n<hr \/>\n<ul style=\"text-align: left;\"><\/ul>\n<ul style=\"text-align: left;\"><\/ul>\n<ul style=\"text-align: left;\"><\/ul>\n<p style=\"text-align: left;\"><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <span style=\"color: #ea593e; text-decoration: underline;\">Common Procedure Codes:<\/span>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0<span style=\"color: #ea593e; text-decoration: underline;\">Anesthesia companies:<\/span><\/strong><\/p>\n<p><strong>EGD (Upper Endoscopy)<\/strong> 43235, 43239\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<strong>GSH Hospital:<\/strong><em> Barrington Anesthesia: 800-242-1131<\/em><\/p>\n<p><strong>Dilation<\/strong> 43248, 43249 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <strong>Northwestern Huntley Hospital:<\/strong><em> Huntley Anesthesia: 847-457-3800<\/em><\/p>\n<p><strong>Colonoscopy<\/strong> 45378, 45380, 45385\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<strong>Pepper Road Endoscopy Center:<\/strong><em> GIP Anesthesia Services: 888-987-1489<\/em><\/p>\n<p><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Algonquin Road Surgery Center:<\/strong> <em>Town Square Anesthesia: 224-231-4805<\/em><\/p>\n<hr \/>\n<h2 style=\"text-align: center;\"><span style=\"color: #ea593e;\"><strong>Coding Questions After Your Procedure:<\/strong><strong>\u00a0<\/strong><\/span><\/h2>\n<p style=\"text-align: left;\">\u00a0 \u00a0 \u00a0 \u00a0 \u00a0Coding is based on provider documentation. Patients with symptoms are not eligible for screening\/preventative colonoscopy. EGD (Upper Endoscopy) is not a preventative procedure. Patients can mail the insurance company a written appeal if they do not agree with how the claim was coded.<\/p>\n<p style=\"text-align: left;\"><strong>\u00a0<\/strong><\/p>\n<ul>\n<li style=\"text-align: left;\">Call insurance to ask for procedure code and diagnosis codes for all claims.<\/li>\n<li style=\"text-align: left;\">If there is a coding discrepancy, call the provider who billed claim.<\/li>\n<li style=\"text-align: left;\"><strong>Hospital <\/strong>claim: Call the Hospital<\/li>\n<li style=\"text-align: left;\"><strong>Anesthesia<\/strong> claim: Call the anesthesia company<\/li>\n<li style=\"text-align: left;\"><strong>Pathology <\/strong>claim: Call the pathology company<\/li>\n<li style=\"text-align: left;\"><strong>Provider<\/strong> claim: Call GI Partners at 815-401-1184 to ask for coding review.<\/li>\n<\/ul>\n<hr \/>\n<h2 class=\"ds-text-heading--3xl ds-h1 ds-u-margin-top--4 ds-u-margin-bottom--2 index-module--content-heading--vGdW8\" style=\"text-align: center;\"><span style=\"color: #ea593e;\">Appealing An Insurance Claim<\/span><\/h2>\n<div class=\"learnParagraph-module--paragraph--SiO+i \">\u00a0 \u00a0 \u00a0 \u00a0 \u00a0If your health insurance company doesn\u2019t pay for a specific health care provider or service, you have the right to appeal the decision and have it reviewed. You must send a <strong>written<\/strong> appeal to your insurance company. If you reached out to your insurance company prior to a test or procedure and the claim was not processed accordingly, the appeal should include the date and reference number from the original call.\u00a0 For more information on how to send a written appeal, please reach out to your insurance company.<\/div>\n<p><\/br><br \/>\n<\/br><\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Understanding Insurance \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Health insurance can be complex due to the various factors that contribute to its cost, coverage options, regulations, and provider networks. These factors can make it difficult for individuals to understand their options and make informed decisions about their coverage. This could lead to unexpected costs and financial burden if you need &#8230; <\/p>\n<div><a href=\"https:\/\/gastrodr.com\/index.php\/understanding-insurance\/\" class=\"more-link\">Read More<\/a><\/div>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-blank-4.php","meta":{"footnotes":""},"class_list":["post-954","page","type-page","status-publish","hentry","no-post-thumbnail"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Understanding Insurance - GI Partners<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gastrodr.com\/index.php\/understanding-insurance\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Understanding Insurance - GI Partners\" \/>\n<meta property=\"og:description\" content=\"Understanding Insurance \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Health insurance can be complex due to the various factors that contribute to its cost, coverage options, regulations, and provider networks. 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