Insurance Carriers

We participate in most of the insurance products from the following insurance carriers*:

BlueCross BlueShield (BCBS)
CarePartners
Cigna
City of Asheville – Primary PhysicianCare
MedCost
Medicare
Medicaid
Mission Hospital
North Carolina State Health Plan
Primary PhysicianCare
United Health Care (UHC)
Well Path (Coventry and First Health)
Western North Carolina Health Coalition (WNCHC)

If your carrier is not listed below then please call our Insurance Department at 828-254-0881 for clarification. We will be happy to provide you with your coverage determination.
* subject to change

We perform charitable medical care to low-income uninsured patients through the following plans:
Buncombe County Medical Society Project Access
Toe River Project Access

Billing

Office Visits-Consultation

Standard office co-pays per your insurance plan will apply to these services.

Procedural Services

Endoscopy services are surgical procedures and will be processed under the surgical provision of your insurance plan. While the procedures are most often just diagnostic nature, they are not considered a diagnostic test by the insurance carrier, nor the American Medical Association. Some insurance plans have exclusions for out-patient surgical procedures or have different out-of-pocket expenses based on the location where the procedure is performed. Deductibles may apply but your office visit co-pays will not apply to these services.

The fees associated with endoscopic services that you can expect to billed for include:
A professional fee for the physician’s services (Asheville Gastroenterology Associates)
A facility fee for use of the surgery facility which provides the equipment, sedation and monitoring (The Endoscopy Center or Hospital)
A fee for pathology services if a tissue sample is submitted for analysis
(ONLY IF ANESTHESIA IS REQUIRED) a fee for anesthesiology services that are rendered during your procedure.

PreCertification

We work with your Insurance, so you don’t have to.

A member of the Insurance Department of Asheville Gastroenterology Associates will contact your insurance carrier to see if pre-certification is required for the procedure. Please note that pre-certification is not a guarantee of payment as per your insurance company.

The correct insurance information must be reported to Asheville Gastroenterology Associates at least 7 days prior to the procedure to allow time for pre-certification. Failure to report the correct insurance may result in you being responsible for the full balance due.

We strongly encourage you to call your insurance carrier to confirm your benefits for the procedure that has been scheduled as well as verifying that pre-certification has been granted if it is required. Be sure to have them review the “screening and/or findings” diagnosis as some plans have limited coverage based on diagnosis.

Also, if you are scheduled for a screening colonoscopy and our findings require treatment, this could change your benefits.