Insurance & Billing Information & Frequently Asked Questions (FAQs)

Most common insurances accepted by Great Lakes Bay Surgery & Endoscopy Center

• Aetna
• Aetna Medicare Advantage
• BCBSM Medicare Advantage
• Blue Care Network (Medicare Advantage & HMO Commercial)
• ChampaVA
• Cigna
• Cofinity/Aetna
• ConnectCare/Key Benefits/JP Farley (MidMichigan Health, Northwood University, MidMichigan Community Health Services, Three Rivers Corporation)
• HAP (formerly Health Plus) (Medicare Advantage, PPO, HMO)
• Humana Cofinity (Medicare Advantage, PPO)
• McLaren Health Plan
• Medicaid
• Medicare
• Medicare Advantage
• Molina
• Multiplan/PHCS
• Priority Health (Medicare Advantage, PPO, HMO)
• Rail Road Medicare
• S.C.Johnson Wax-United Health Care (ONLY SC Johnson)
• TriCare (Non-HMO)
• US Health and Life
• We also accept all Workers Compensation Plans and Auto.

What is a co-payment (co-pay)?

All co-payments must be paid at or prior to the time of service. The co-pay is (usually) a capped contribution, determined by your insurance contract, payable by the patient each time a medical service is rendered.

What is a deductible? What about co-insurance?

If applicable, your estimated deductible and co-insurance information will be provided to you prior to your procedure. A deductible is the amount you must pay out-of-pocket for services prior to your insurance company providing reimbursement. Similarly, co-insurance is an amount agreed upon in your insurance contract which outlines shared responsibility for reimbursement totals, usually comprised of a percentage of the total amount. Sometimes this is affected by your deductible; therefore, it is recommended that you reference your individual insurance policy for the most accurate and up-to-date information.

What is the patient responsibility?

At times, based on the contractual obligations assigned to you by your insurance carrier and due to various circumstances of the surgical procedure(s), your insurance provider will assign a specific amount as ‘Patient Responsibility’ after your claim has been filed and processed.  This can include, but is not limited to, your deductible, co-pay, and co-insurance and is often calculated based on other medical expenses which have been incurred and filed for pre/post-surgery. This amount is found on each patient’s Explanation of Benefits (EOB) from their insurance company. Any assigned balances remaining after your insurance provider has made applicable reimbursement payments are defined as Patient Responsibility.

Can Great Lakes Bay Endoscopy and Surgery Center provide me with an estimate for the cost of my procedure?

In order to ensure the best possible patient experience, Great Lakes Bay Surgery and Endoscopy Center will work on your behalf to obtain the most accurate information from your insurance provider(s) and calculate various factors to provide you with the most accurate pre-surgery estimate.  It is our intent that this value is as accurate as possible; however, based on circumstance outside of our control this may change. That being said, any amounts provided prior to surgery can only be taken as good faith estimates. Any and all final balances will be billed to you according to our standard Billing Guidelines.  Should you have any questions related to your estimate, please contact our Insurance Verification Clerk at 989-450-9100.

What is pre-authorization?

Many insurance providers require a pre-authorization for surgical procedures. It is the responsibility of your physician’s office to obtain any pre-authorization necessary for your procedure. In conjunction with verifying benefits with your insurance provider(s), we will attempt to coordinate with the physician’s office to ensure (if necessary) that your pre-authorization has been obtained.

At times, the insurance carrier will need additional information from the patient as it pertains to verifying these pre-authorizations. We ask that you be diligent in your response to said carriers as it may affect the scheduling of your surgical procedure.

Worker's Compensation

If your scheduled procedure is the result of a work-related injury, Great Lakes Bay Surgery and Endoscopy Center will require your worker’s compensation insurance information as well as your personal health insurance information. It is standard practice in these claims for your employer to provide you with their Worker’s Compensation Insurance Carrier information. This includes the provider name and contact number, a contact person and a claim number. Any worker’s compensations claims denied by your employer’s worker’s compensation provider will become your sole responsibility.

Self-pay Accounts

For patients undergoing surgical procedures who are uninsured/self-pay, an estimate will be provided to you by our Insurance Verification Clerk. It is our expectation that, at a minimum, 50% will be due before or at the time of service, with any remaining balance due after a statement is mailed to you.

What methods of payment are accepted by Great Lakes Bay Surgery & Endoscopy Center?

For your convenience we accept all major credit/debit cards (Visa, MasterCard, American Express, and Discover), cash, and checks (personal or cashier’s).

Why am I receiving multiple bills for my procedure?

You can expect to receive separate bills related to your surgical procedure(s) and/or course of treatment.  These include but are not limited to:

  • Physician (individual fees)
  • Anesthesiologist (individual fees)
  • Laboratory (if applicable – testing fee)
  • Radiology (if applicable – imaging fee)
  • Great Lakes Bay Surgery and Endoscopy and Surgery Center (facility fee)

Great Lakes Bay Surgery and Endoscopy Center Insurance staff members are more than happy to assist you with questions related to your facility statements, and (if possible) will assist with additional billing questions. However, it is recommend that you direct any specific questions to those parties directly.  Due to HIPPA, we are not always able to communicate with the various billing departments for each entity, so unfortunately there are questions we will be unable to assist with as it is confidential information relating to your account with those entities.

Financial Policies

Excellent clinical care is our main objective at Great Lakes Bay Surgery and Endoscopy Center. In order to make our care available to most, we offer a variety of payment plan options. Please contact our Insurance Verification Clerk to discuss your specific requests or needs at 989-495-9100.

Returned (NSF) Checks

Great Lakes Bay Surgery and Endoscopy Center is happy to accept personal and/or cashier’s checks for payment on accounts. As part of this service, we institute an industry-standard fee of $35 on any checks returned for insufficient funds. This fee will be added to your account balance. Should checks be returned for insufficient funds on more than one occasion to an account, we will no longer accept personal checks as a form of payment used to satisfy said account. A representative will contact you to discuss further action if necessary.

Collection of Delinquent Accounts

If a patient account becomes delinquent, the account will be turned over to a collection agency. This policy is in effect for any and all patients receiving care at Great Lakes Bay Surgery and Endoscopy Center. An account is deemed delinquent if payment has not (ever) been received, payments are missed for three consecutive billing cycles (90 days), payment has missed the billing cycle following a NSF check, deviation from agreed upon payment plans, or multiple returned (mail) statements to Great lakes Bay Surgery and Endoscopy Center.

Collection activity can negatively impact your credit report. The team at Great Lakes Bay Surgery and Endoscopy Center does not wish this to happen, but unfortunately, in order to be able to provide the excellent quality care we do, it is necessary to have these provisions in place. If at any point you become unable to meet your financial obligations, move, or have any other circumstance which would ultimately affect your financial status, please contact our Patient Billing Department at 989-423-0220 Opt 1 as soon as possible to discuss your situation and work towards a mutually beneficial solution.

Need assistance making payment arrangements? 

CareCredit can help. Care Credit is different than a regular credit card and can be used for out-of-pocket expenses not covered by medical insurance. Special financing options are available that you may not be able to get with other cards. Click the image below to learn more.