Insurance & Billing

Your procedure at Endoscopy Center of Santa Monica, an Ambulatory Surgery Center, will involve a number of separate and distinct services that will be billed to your insurance.

  • Endoscopy Center of Santa Monica Facility Fee
  • Assistant Surgeon/Physician Assistant Fee (if applicable)
  • Anesthesia Fee (If applicable)
  • Lab/Pathology Fee (If Applicable)

Co-Pays

Your insurance plan may have different coverage levels for different services. For example, you may be responsible for paying your physician a co-pay for his/her professional fees for procedure. In addition to the physician co-pay, you may also have a facility co-pay. Payment is expected at the time of service.

Co-Insurance

Co-insurance is a percentage of the procedure charges (e.g., insurance plan pays 80% and you pay 20%), subject to your plan’s coverage limits. You may owe co-insurance to either the physician or endoscopy center or both. Also be aware that co-insurance may be in addition to your co-pay. Payment is expected at the time of service.

Deductibles

You may also have an annual deductible amount that must be met by you prior to any payment of services by your insurance. In this case, you may have both an annual deductible and co-insurance that is your responsibility. Payment is expected at the time of service.

Every insurance plan is different. You may have a co-pay, co-insurance, and deductible or some combination of the three. It is your responsibility to understand your plan and benefits – we can help. Prior to procedure you will receive a call from Endoscopy Center of Santa Monica’s partner at Sovereign Healthcare. We will verify your insurance and give you a estimate of your patient responsibility, based on what your physicia has scheduled. The amount that is quoted to you is based on Endoscopy Center of Santa Monica’s contracted rate with your insurance. You estimated patient responsibility is due at the time of service.

Before Your Procedure

Now that your procedure has been scheduled you will receive a call from Endoscopy Center of Santa Monica's partners at Sovereign Healthcare to discuss your procedure. Since we’ve already verified your insurance benefits, this call will be to confirm the information we received from your insurance company and physician’s office is correct and to let you know what your co-pay/co-insurance payment/deductible amount will be on the day of your procedure. If you don’t have a copay/co-insurance payment due, or if you have secondary insurance, then you may not have any payment due on the day of your procedure.

Day of Your Procedure

Please remember to bring all insurance cards and other pertinent documents with you on the day of surgery so that we may process your insurance papers for you. We accept American Express, Visa, and MasterCard with credit card approval on the date of payment. We also accept personal checks and cash at the facility.

Cash payments must be made for the exact amount due. We are not able to provide change at the facility.

Get In Touch With Us

If you would like to receive more information or to provide us with feedback on those areas where we have done well, and those where we may need to improve, please fill out the form below and a representative will get back to you shortly. If this is a medical emergency, call 911 immediately. For your security, please do not use email to share personal information, health information, social security numbers or credit card numbers. Instead, we recommend contacting your clinic and/or doctor directly.