Insurance

Understanding Your Insurance & Billing

If you are using insurance, we require a valid ID and your current insurance card at each visit to verify your benefits. We will attempt to obtain details about your insurance coverage and collect an estimate of what you will owe based on the information we receive regarding your plan. Please note that verification of benefits is only an estimate.

Copayment or copay is a flat fee that you pay for certain services such as an office visit or procedure. The average copay amount for a specialist visit is typically $50 - $80 depending on your insurance plan.

Deductible: The amount you pay for healthcare before your health insurance begins to pay. You pay for 100% of your medical care until your deductible is met. Once your deductible is met, you and your insurance plan will share in the cost of care as outlined in your insurance policy. If you have not met your deductible, you can expect to pay for 100% of your medical care

Coinsurance: Your share of the costs of a visit, procedure or test once you have met your deductible for the year. Depending on your insurance plan, you pay a percentage of the cost.

Out-of-pocket maximum: Any expenses you are personally responsible for paying: deductible, coinsurance, copays and any health care expense that adds up to your out-of-pocket amount outlined in your policy. Once your maximum is met, your insurance provider will cover costs at 100% (co-pay amounts may not be included).

Endoscopy Center Billing & Insurance: DHAT partners with North Texas Endoscopy Centers (NTEC) to perform outpatient GI services such as upper endoscopy and colonoscopy. If you have a procedure done at one of our centers, you will receive a bill from North Texas Endoscopy Centers. In the event, your physician performs your procedure at a hospital or other Endoscopy Center the same process would apply. You may also receive a separate bill from pathology and anesthesia providers.

About Your Bill: It is our policy to estimate your financial responsibility and collect any known copay, coinsurance and deductibles at your appointment. This is an estimate. If there is a balance due, after your insurance has processed your claim, we will send you a statement.

Screening Colonoscopies: Most insurance plans cover a screening colonoscopy at 100%. If you have a personal history of polyps, cancer, or inflammatory bowel disease (IBD) your plan may consider this a diagnostic service. As a result, a copay, deductible or coinsurance may apply.

In the event your deductible applies, below is an example of your estimated cost. In this example, the patient has a $1,000 deductible and the insurance allows $2,500.

Contact DHAT’s Central Billing Office if you have questions about your billing statement at 214-623-6230.