For patients

Billing and Insurance

Accepted Insurance

Listed below are the insurance companies with which Borland Groover is a participating provider. If your insurance plan is not listed as one we participate in, please contact your insurance carrier and request they add us to their panel.

If you have any questions, please contact us or use our online form to schedule an appointment today.

 

  • Aetna (Select Choice, HMO, Quality POS, Managed Choice POS, Open Choice PPO)
  • Ascension
  • Avmed
  • Blue Cross Blue Shield (BCBS)
  • Beech Street
  • CarePlus
  • CCN
  • Cigna (HMO, POS, PPO)
  • CIGNA Medicare Access
  • Coventry National
  • Devoted
  • First Health
  • Florida Health Alliance
  • Florida Health Care (Triple Options and Medicare only in Volusia)
  • Florida Memorial Health Network
  • GEHA
  • Great West
  • Health Smart
  • Humana
  • Humana Medicare Gold Choice PPO
  • Medicare
  • MultiPlan
  • Private Health Care System (PHCS)
  • Sunshine Health
  • Travelers Medicare
  • Tricare 
  • Tricare for Life (Prime/Standard ONLY)
  • United Healthcare (PPO, HMO, Choice Plus, Ideal, Select/Select Plus)
  • Veteran’s Health Administration
  • Volusia Health Network

 


Uninsured Options

For our patients that are uninsured or have the financial inability to pay for medical expenses there may be an option for you. Contact us for more information.

We Care

We Care provides health care access to the uninsured and underserved by coordinating medical volunteers and donated health services. If you do not have the financial ability to pay for your health care needs, contact We Care at 904.674.6450 or visit WeCareJacksonville.org

Borland Groover offers discounted rates for patients who do not have insurance or qualify for WeCare services. If you would like further information on those rates, please contact our billing department at 904.398.7205.

 


Colonoscopy Coverage

Today, many insurance plans provide some preventive services, such as colonoscopies, that are covered at no cost to you. Unfortunately, strict guidelines are used to determine which category of colonoscopy can be defined as a screening/preventive service. These guidelines may exclude those patients with any current gastrointestinal signs and symptoms, history of gastrointestinal disease, a personal or family history of colon polyps or colon cancer from taking advantage of the procedure at no cost. In cases like these, patients may be required to pay copays, coinsurance and/or deductibles.

Please Note: Although your primary care provider may refer you for a “screening” colonoscopy, you may not qualify for the “preventive/screening colonoscopy” benefit under your insurance plan.

There are three colonoscopy categories:

  • Diagnostic/therapeutic colonoscopy – If you have any gastrointestinal symptoms (i.e, diarrhea, constipation, rectal bleeding, abdominal pain, etc.), colon polyps, iron deficiency anemia, gastrointestinal disease or other abnormal tests requiring evaluation or treatment by colonoscopy. Usually subject to copay, coinsurance and/or deductible.
  • Surveillance/high risk colonoscopy – If you are asymptomatic (no current gastrointestinal symptoms) and have a personal history of gastrointestinal disease, such as diverticulitis, Crohn’s disease or ulcerative colitis, and/or a personal or family history of colon polyps and/or colon cancer. Patients in this category are required to undergo colonoscopy surveillance at shortened intervals, usually every 2 – 5 years. Costs may be subject to copay, coinsurance and/or deductible.
  • Screening/preventive colonoscopy – If you are asymptomatic (no current gastrointestinal symptoms), age 45* or older and have no personal history of gastrointestinal disease, no personal or family history of colon polyps and/or cancer. Patients in this category have not had a colonoscopy, or other screening for colon cancer, within the last 10 years. If these guidelines are met, costs may be covered at 100% under your plan.

Common Questions about Colonoscopy Coverage

Who will bill me?

You may receive separate bills from multiple entities associated with your procedure, such as the physician, facility, anesthesia or pathology.

If I have signs or symptoms and told my physician, can I ask him to change it so screening/preventive benefits apply to my care?

No. Any medical information you shared with your physician during your visit has been documented in the medical record and is a binding legal document that cannot be changed or altered to facilitate better insurance coverage.

What if my health plan tells me that my physician can change symptoms or a diagnosis code for screening/preventive benefits?

Your insurance may tell you that your procedure, if coded as a screening, will be covered at 100%. However, if your procedure does not meet the definition of a screening/preventive then it cannot be re-coded and filed as a screening/preventive colonoscopy.

Will someone call me with information of what I owe?

We want to make sure you are getting the correct benefits from your health plan. Our office will inquire with your health plan to obtain your copay and deductible benefits and determine if an authorization is required. You may have to pay a deposit on the date of your procedure. Our financial counselor will call you in advance to notify you of this expectation. We can never guarantee how your health insurance will pay for your services. It is always a good idea to call your health plan and understand your benefits.

Our Services

Borland Groover provides comprehensive gastroenterology care aimed at providing cutting-edge technology coupled with state-of-the-art gastroenterology services in a quality-infused environment.

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