If you owe more than a copay, we will contact you by phone at least a week prior to your scheduled procedure. At that time we will notify you of what your estimated financial responsibility will be. The estimated fee will be due on the day of your procedure. Please keep in mind that we can only quote you an estimate of what your insurance company tells us.
- You will be charged both a professional fee and a facility fee. Your insurance company will determine your benefits and there may be a balance from the professional fee and the facility fee for you to pay.
- If you have any tissue specimens removed during the procedure, you will receive a separate pathology bill for the tissue analysis.
- You will receive a separate bill from Anesthesia Care Services, PA for their services of deep sedation for the procedure.
- If you have any questions about your anesthesia fees please call: (888) 447-7220 or (336) 884-4595
After the insurance company has been billed and paid, the patient will be responsible for the remaining balance.
Any procedure cancellation must be made at least 48 hours prior to the scheduled procedure. There is a $50 cancellation fee for failure of notification.
Rights and Responsibilities
Your Rights as a Patient
When are well informed, participate in treatment decisions, and talk openly with your doctor and office staff, then you help make your care more effective.
Patient Rights – You have a right to:
- Considerate, respectful, and safe care.
- A discussion of your illness, what we can do about it, and the likely outcome of care.
- Know the names and roles of the people caring for you here.
- Respectful and effective pain management.
- Receive as much information to consent to or refuse a course of treatment or invasive procedure and to actively participate in decisions regarding your medical care.
- Involve your health care proxy or significant others in the decision making process for medical decisions.
- Receive information regarding Advance Directives – available upon request.
- Reasonable continuity of care and to know in advance the time and location of an appointment as well as the doctor you are seeing.
- Full consideration of privacy and confidentiality of your medical information. Your written permission will be obtained prior to releasing any medical information. When we do release your information to others, we ask them to keep them confidential.
- Review your medical record and ask questions unless restricted by law.
- Know of any relationships with other parties that may influence your care.
- Know about rules that affect your care and about charges and payment methods. You have a right to receive and examine an explanation of your bill regardless of the source of payment.
- Choose your own physician or an external physician not in our practice.
- Voice your concerns, complaints, or problems with the care you received by contacting our Practice Administrator or Endoscopy Coordinator. If we are unable to satisfactorily address your complaint, you may contact the NC Medical Board via e-mail at ncmedboard.org or by telephone 1-800-253-9653 or you can go to www.cms.hhs.gov/center/ombudsman.asp which is the website for the Office of the Medicare Beneficiary Ombudsman.
Patient Responsibilities – You agree to
- Provide accurate and complete information concerning your symptoms, past history, and current health status.
- Make known whether you clearly comprehend your medical care and what is expected of you in the plan of care.
- Follow the treatment plan and care instructions given to you.
- Keep appointments and notify us if you are unable to do so.
- Accept responsibility for your actions if you refuse planned treatment or do not follow your doctor’s orders.
- Accept financial responsibility for care received and pay promptly.
- Follow facility policies and procedures.
- Be considerate of the rights of other patients and staff.
- Be respectful of your personal property and of others in the facility.
- Inform the staff of any discomfort or pain and patient safety issues.
- Share your values, beliefs, and traditions to help the staff provide appropriate care.
- If you are interested in any additional information about advanced directives, certain forms can be supplied if requested by contacting our office.
Cary Endoscopy Center is owned and operated by H. Paul Singh, MD and Rajendraprasad Makam, MD