Insurance and Billing FAQ

Insurance will process the procedure claim(s) based on the patient’s policy. If you have a procedure at one of our Ambulatory Surgery Centers, there will be 2 to 3 claims submitted to your insurance plan(s) by Dayton Gastroenterology: the physician, the facility, and pathology (if a specimen was collected).

Each procedure is unique to each patient. Some procedures involve multiple methods of treatment. Each treatment (biopsy, polyp, dilatation, injection, and additional pathology codes, etc.) is coded separately; more than one CPT code can be billed for the procedure from the physician, facility, and pathology.

Anesthesia services will be billed separately by Western Ohio Sedation Associates, LLC (WOSA). Western Ohio Sedation Associates, LLC contracts and employs certified registered nurse anesthetists as part of the anesthesia care team. For billing questions or concerns, please call 1-888-337-3509 or 937-395-2591, or visit www.westernohiosedationassociates.com.

A copay is a fixed amount that you will be responsible for at the time of service determined by your insurance provider. Sometimes, copays will be listed on your insurance card. If they are not listed on your card, please contact your insurance provider.

Because Dayton Gastro is considered a specialty physician, please be aware that your copay may be higher than the copay for your primary care physician.

Dayton Gastro does assess a $20 fee if copays are not paid at the time of service.

If you have a procedure at one of our ambulatory surgery centers, 2 to 3 claims will be submitted to your insurance plan(s): the physician, the facility, and pathology (if a specimen was collected). Most insurance plans process and pay these claims separately. Western Ohio Sedation Associates processing their own statements.

Yes we do offer the following; please contact the Business Office at 937-320-5050 option 4 to review which option will fit your financial needs.

• Payment Plans
• Self-pay Fee Schedule: If you do not have insurance, Dayton Gastro has set up a fee schedule for office visits and procedures. These self-pay fees will be collected at the time of service.

Dayton Gastro accepts these options for payment: cash, check, money order, and all major credit cards/debit cards.

You have three options to pay your Dayton Gastro bill:

• Mail in the cash, or check with your statement.
• Call the business office at 937-320-5050 to pay with your credit/debit card over the phone.
• Pay via our Patient Portal. If you do not yet have your patient portal set up with Dayton Gastro, please contact us.

There are 3 types of Colonoscopies: Screening, Diagnostic and Surveillance. Please review the following definitions and call your insurance plan(s) to check benefits.

• Screening/Preventive – Patient is asymptomatic (no gastrointestinal symptoms either past or present), over the age of 50, has no personal or family history of GI disease, colon polyps, and/or cancer. The last Colonoscopy was 10 years or greater.
• Diagnostic – Patient has past and/or present gastrointestinal symptoms, polyps, GI disease, iron deficiency anemia and/or any abnormal tests.
• Surveillance/High Risk Screening – Patient is asymptomatic (no gastrointestinal symptoms either past or present), has a personal history of GI disease, colon polyps, and/or cancer and family history of colon polyps, and/or cancer (with last Colonoscopy less than 10 years ago). Surveillance/High Risk Screening Colonoscopies are recommended every 2 years or more.