Insurance, Billing and Self-Pay Options in Fort Smith

Insurance plans we accept

Digestive & Liver Center of Arkansas works with most of the major health plans used in Fort Smith and across the River Valley. For most patients, that means you can get your GI, liver and hemorrhoid care close to home without changing doctors or driving to another city. We accept:

• Medicare
• Arkansas Medicaid
• Oklahoma Medicaid (helpful for our patients in Poteau, Sallisaw and eastern Oklahoma)
• Managed Medicaid plans: Aetna Better Health, Humana Healthy Horizons, Oklahoma Complete Health and PASSE
• Blue Cross and Blue Shield
• UnitedHealthcare and UMR
• Cigna
• Aetna
• Humana
• Ambetter
• HealthChoice
• Veterans / VA coverage
• Uninsured and self-pay patients, with pricing quoted up front Plans change from year to year, and some employer plans use a narrower network than others. Insurers also update their provider networks during the year, so a plan that covered us last visit is worth rechecking if it has been a while. The safest step is a quick call with your card in hand. Our staff will check your exact plan before your visit and tell you what we find.

Why one colonoscopy is billed as screening and another as diagnostic

Two people can have the very same procedure and receive two different bills. That is because insurance pays based on why the test was ordered, not on what happens during it. A screening colonoscopy is done when you have no symptoms and you are simply due for colon cancer screening. For adults at average risk, screening now begins at age 45. Most health plans are required to cover preventive screening with no copay or deductible, and Medicare covers screening colonoscopy as well. A diagnostic colonoscopy is done because something needs an answer: rectal bleeding, low blood counts, ongoing diarrhea, abdominal pain, or an abnormal test result. Because it is treating a problem rather than preventing one, it is usually billed under your regular medical benefits, so your deductible and coinsurance may apply. A surveillance colonoscopy is a repeat exam because of past polyps, a personal history of colon cancer, or a strong family history. Plans differ on whether they treat these as preventive, so we check yours ahead of time. A few points that often surprise people:

• If a polyp is found and removed during a screening exam, most plans still treat the visit as preventive. Medicare is also phasing out the coinsurance that used to apply in that situation.
• A colonoscopy done to follow up a positive at-home stool test is generally treated as preventive by most plans.
• If you have symptoms such as rectal bleeding, tell us. Bleeding is common with hemorrhoids, but it still deserves a look, and it can change how the visit is coded. You can read more about the exam itself on our colonoscopy page.

What to bring so your visit bills correctly

• A photo ID
• Your insurance card, plus any secondary or supplemental card
• Your Medicare or Medicaid card, if that applies
• A current list of your medicines, including doses
• Any referral or authorization your plan requires
• Reports or records from other doctors, if you have them
• Your completed new patient forms

How we verify your benefits before a procedure

We would rather you know what to expect than be surprised weeks later. Before a scheduled procedure, our team typically:

1. Confirms that your plan is active and that we are in network for it.
2. Checks your deductible, coinsurance and any copay that applies.
3. Requests prior authorization when your plan requires one.
4. Calls you with what your plan reports, so you can plan for it. One honest caution: what a plan quotes before a procedure is an estimate, not a promise. The final amount depends on how your plan processes the claim and on what your deductible has already absorbed for the year. For liver testing such as FibroScan or a medical weight-loss visit, you can reach our billing team directly at (479) 242-2888.

Self-pay options and clear quotes

If you do not have insurance, or your plan does not cover an elective service, we offer self-pay pricing for many services and we quote it up front. Call and ask; you will get a number before you commit, not after. If you are uninsured or choosing to pay yourself, federal law also gives you the right to a written Good Faith Estimate of expected charges before a scheduled service. Just ask our billing staff and we will prepare one. Coverage for weight-loss medicines varies more than almost anything else in medicine. Some plans cover them well, some not at all. We check first, then talk with you about options.

Financial questions are welcome here

Nobody should skip a colonoscopy or a liver evaluation because they are afraid of the bill. Ask us. Ask early. Our staff answers cost and coverage questions every day, and no question is too small or too awkward.