Insurance

Gastrointestinal endoscopy procedures may be performed in this facility by any doctor who is qualified and granted privileges by the governing board of HEC. The same as at a hospital or other Ambulatory Surgery Center, there is a facility fee for the use of the facility, its personnel and equipment. This fee is separate from the doctor’s professional fee and anesthesia services provided by the Certified Registered Nurse Anesthetist (CRNA).

MEDICARE

HEC is licensed and approved by Medicare. We will bill Medicare directly for payment of the facility fee. You will receive an Explanation of Benefits (EOB) from Medicare and are responsible for the annual deductible and co-insurance.

CAPITAL BLUE CROSS

HEC participates with Capital Blue Cross (CBC). We will bill CBC directly for payment of the facility fee. You will receive an Explanation of Benefits (EOB) from the insurance company and are responsible for any deductibles or co-insurance that may be due.

HIGHMARK BLUE SHIELD

HEC participates with Highmark Blue Shield (HBS). We will bill HBS directly for payment of the facility fee. You will receive an Explanation of Benefits (EOB) from the insurance company and are responsible for any deductibles or co-insurance that may be due.

COMMERCIAL INSURANCE

Each insurance company has its own benefits package and policy regarding payment of the facility fee. In general, we will bill the insurance company directly. You will receive an Explanation of Benefits (EOB) from the insurance company and are responsible for any deductibles or co-insurance that may be due.

MANAGED HEALTH CARE PLANS (HMO’S)

HEC is a participating member of the following:

Health America
Keystone Health Plan
Aetna/US Health Care
United Health Care

Most plans require an authorization form or number be brought from the primary care physician’s office. We will help you to obtain this form. We will bill the insurance company directly. You will receive an Explanation of Benefits (EOB) from the insurance company and are responsible for any deductibles or co-insurance that may be due.

PRECERTIFICATION

Please notify us prior to your appointment if your insurance requires precertification for outpatient procedures. If you do not know whether your insurance requires precertification, closely examine your cards or check with your insurance provider.

ANESTHESIA

Any time anesthesia is given by the Certified Registered Nurse Anesthetist (CRNA), our group, Hershey Anesthesia, will bill your insurance company directly. Hershey Anesthesia participates with the same insurance groups as HEC.

Our business personnel are willing to help you with your billing questions.

PHYSICIAN FEES

In addition to the facility and anesthesia fees, you will be billed for the physician’s services. This bill will be submitted to your insurance company by the Hershey Medical Center billing office.