Government-Public Health Plans
Digestive Health Associates, PC is a private office-based medical practice. Our capacity to provide care under government-sponsored health plans is limited. Our participation in these plans is defined by the terms of our participation agreements. Please contact your government health plan directly regarding questions concerning your level of covered benefits or the manner in which the plan determines eligibility for or payment for a particular medical service.
Our Current Public Plan Status
We are participating providers for Medicare, Champus (Tricare)/ChampVA, and Colorado Medicaid.
Effective January 1, 2011 we are limiting our acceptance of new Medicare and Champus (Tricare)/ChampVA patients to residents of Colorado.
Champus (Tricare) and ChampVA. Our capacity to accept new Champus patients is limited. Effective January 1, 2011 we are limiting our acceptance of new Champus patients to residents of Colorado.
Colorado Medicaid. We do not participate in out-of-state Medicaid plans. Our capacity to accept new Medicaid patients is limited. We may restrict our acceptance of new Medicaid patients from time to time.
Medicare. Our capacity to accept new Medicare patients is limited. Effective January 1, 2011 we are limiting our acceptance of new Medicare patients to residents of Colorado. Please contact the Medicare program directly at 800.633.4227 for assistance with Medicare benefits. Please be aware that information reported on Medicare's Physician Compare web site is highly inaccurate. We recommend that all information reported on this site be independently verified directly with your physician's office. The unreliability of this widely-touted government site is a national problem that is known to the Center for Medicare and Medicaid Services (CMS).
Download Medicare & You 2012 | Medicare Contact Information
Other Health Plans
In some cases, depending on network agreements between plans and your own coverage, in-network benefits may also be available for the following carriers and plans. It is critical however that you verify the specific details of Digestive Health's relationship with these plans before your care is rendered:
Aetna
GEHA
Great West
HMN
Multiplan
Plans contracted with Digestive Health are also contracted with the Southwest Endoscopy Center, which is a licensed ambulatory surgery center that is required by law to function as an independent entity and bill separately for its services.
Other entities with which we are affiliated or partner with in your care, such as Mercy Regional Medical Center, Southwest Diagnostic Laboratories, PC (our pathologist's private practice located at Mercy Regional Medical Center) and Animas Anesthesia Associates, LLC (our anesthesia provider at the Southwest Endoscopy Center), may maintain not contract with the same plans.
If you have a plan which is not listed above please contact our facility administrator, Ms. Marianne Sloan, with regard to the possibility of initiating contracting discussions with your insurer. It is important to let your insurance company representative know that it does not have a complete network of providers. Insist that they add gastroenterology services for Southwest Colorado to their provider network.
Please call us if you have any questions regarding our insurance plan participation.
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