INSURANCE AND BILLING

DDM works with the following insurance providers:

 

  • AARP
  • AETNA/AETNA PPO
  • AMERICAN POSTAL WORKERS
  • AMERICAN PROGRESSIVE
  • AMERICAN PROGRESSIVE PREM
  • CD PHP
  • CD PHP MEDICARE
  • CHAMPVA
  • CIGNA HEALTHCARE
  • DEFINITY HEALTH
  • EMBLEM HEALTH
  • EXCELLUS BCBS
  • FIDELIS
  • FIDELIS MEDICARE ADVANT
  • FIRS UNITED AMERICAN LIFE
  • GHI
  • GREAT WEST LIFE
  • HUMANA
  • LIFETIME BENEFIT SOL.
  • MAILHANDLERS
  • MEDICAID NY

 

 

  • MEDICARE RAILROAD
  • MERITAIN HEALTH/REVERE
  • MVP
  • NATIONAL GOVERNMENT SERV
  • ONEIDA INDIAN HEALTH SER
  • OPTUM
  • PARTNERS HEALTH PLAN
  • TRICARE EAST
  • UHC COMMUNITY PLAN
  • UHC MEDICARE ADVANTAGE
  • UMR
  • UNITED HEALTHCARE
  • UNITED HEALTHCARE – EMPIRE
  • UNIVERA
  • UPSTATE ADMINISTRATIVE
  • VETERANS NON VA CARE 136E
  • WELLCARE
  • WELLS FARGO TPA

At Digestive Disease Medicine, our goal is to provide the best care available through understanding our patient’s needs for service, regardless of race, religion, or economic background.

Through the billing department, we will do our best to provide you with the knowledge of our services and the financial arrangements for the medical care provided. We are committed to providing the best quality care while understanding the need to limit services to only those necessary. Digestive Disease Medicine works with many insurance providers and insurance plans. Our billing department will file the appropriate reimbursement claims efficiently and effectively. Deductibles and co-payments will be the patient’s responsibility at the time of his/her visit. Any non-payment fees not covered by the insurance provider will be the patient’s financial responsibility. Patients will receive a bill for their balance, with the appropriate adjustments due upon receiving the bill.

Participating Insurances:

Digestive Disease Medicine participates in many insurance plans and health insurance companies. Insurances are continually changing, and it is recommended that you stay up to date with your specific coverage and plans. When calling in for an appointment, be sure to provide your current insurance plan and policy number.   If the Center does not participate in the network of a patient’s health care plan, the amount or estimated amount the patient will be billed for health care services is available upon request. Contact the billing office at 315-624-7000 to make a request.

Hospital Affiliations:

DDM is affiliated with the Mohawk Valley Health System (Faxton- St. Luke’s Healthcare and St. Elizabeth’s Medical Center).

Cancellation Policy:

Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care. DDM charges a  $50.00 fee for all missed appointments (“no shows”) and appointments, which, absent a compelling reason, are not canceled. A 48-hour notice is required for office appointments, and 72- hour notice is required for surgical procedures. This fee must be paid in full prior to scheduling any future appointments. We ask that you cancel only under the most stringent circumstances as your health is of utmost importance to us.

 

Surprise Billing

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call             315-624-7000

 

Billing Related Inquiries:

For all billing related questions (including Anesthesia and Pathology), please contact us at:

Digestive Disease Medicine Billing Department

DDM related billing inquiries

please call 315-362-5287,

PO BOX 2003, East Syracuse, NY 13057