Why does MGI use anesthesia services now?

Our practice began using monitored anesthesia care for scopes done at our Endoscopy Center in 2013. With propofol, a drug that is FDA-approved for sedation, we found improved patient comfort, better polyp detection rates, and faster recovery of our patients. A CRNA administers the sedation while the GI specialist attends to the procedure.

Will my insurance pay for anesthesia services?

It is always best to contact your insurance carrier as plans may differ. Screening colonoscopy: Medicare and most commercial carriers will cover MAC anesthesia under preventative benefits. However, when a polyp is removed during a screening colonoscopy Medicare will waive the deductible and co-insurance will apply. Medical procedures: Medicare and most commercial carriers will consider under medical benefits applying deductible and co-insurance.

Why is there an increase in cost for anesthesia services?

MGI feels the value of this type of sedation is worth the cost. We are very cost-conscious, and this is why we built lower cost free-standing endoscopy centers so patients would not have to visit the hospital for an endoscopy.

The hospitals now, for the most part, all use this type of anesthesia exclusively. Our use of monitored anesthesia care, or propofol, is still very cost-effective.

Can I have my procedure without anesthesia services?

We are willing to accommodate this request for most patients, depending on medical history and current medications. Please contact our office to make this request for your procedure

Can I pay my bill online?

Yes, you may pay your bill online here. We accept Visa, MasterCard, American Express and Discover.

Will my insurance company be billed for my services?

Yes, as a convenience to you, our office will bill your insurance company, provided we are given current insurance information.  Balance is ultimately patient responsibility.  It is the responsibility of the patient to verify insurance information and to follow up with their insurance company to ensure bills are paid in a timely manner.

Will I receive more than one bill?

It is possible to receive separate bills from entities associated with your services.  Examples of billing may include the physician, facility, anesthesia, pathologist and/or lab.

My primary care physician referred me to your office for a screening colonoscopy. Why wasn’t it billed as a screening or preventative colonoscopy?

To bill for a screening colonoscopy the patient must be without gastrointestinal symptoms, 50 years of age or older, have no personal history of gastrointestinal disease, colon polyps and/or colon cancer.  In most cases patients are limited to one screening colonoscopy per ten year increment.

It is a common occurrence for insurance providers/carriers to recommend contacting physicians’ offices to change claim coding to pay claims at 100%.  Should a claim meet all of the criteria listed above, our office will certainly review records and submit changes if appropriate.  However, in most cases, screening benefits will be denied due to age, symptoms, or time interval restrictions.

Our billing office is available at (402) 397-7057 or (402) 504-3880 during regular business hours to answer questions regarding your claim and Medicare and American Medical Association (AMA) coding policies.

Why can’t the coding on my claim be changed so my insurance company will pay the bill in full?

Our certified coders follow the guidelines of the Centers for Medicare and Medicaid Services and the AMA and code according to the physician’s documentation in your medical record.  Due to strict government regulations, insurance company documentation and coding guidelines, physicians are prevented from altering chart records for the purpose of coverage determination.  Altering chart documentation is considered fraudulent and is punishable by law.

What is a medical or diagnostic colonoscopy?

A medical or diagnostic colonoscopy is performed when a patient has past and /or present gastrointestinal symptoms, polyps or gastrointestinal disease or a history of colon cancer.

If the physician removes a polyp during a screening colonoscopy, will this change my out of pocket responsibility?

Physicians are required by law to report the removal of a polyp.  Based on individual policies, your insurance company will process the claim and determine your payable benefits.  However, we will indicate to your insurance that the scheduled and primary reason for your visit is a screening colonoscopy.

I was required to pay a down payment at the time of service. What if my insurance covers a portion of my payment?

All overpayments are refunded to the patient or the insurance carrier depending on to whom the monies are due.  Refunds are sent out within 30 days of the overpayment to the appropriate party.

I cannot afford to pay my balance in full. Can I set up a payment arrangement for the balance?

It is to your benefit to pay your balance in full, if possible.  However, our office offers prearranged payment plans for those who qualify.   A valid payment plan must be prearranged and within our payment guidelines.  Our billing office is available at (402) 397-7057 or (402) 504-3880, during regular business hours to answer questions regarding your bill or payment arrangements.

When will I receive my first statement?

Provided our office receives current insurance information, you will receive a statement following insurance payment or denial.  A monthly statement will be mailed every 30 days until the balance is paid in full.

How are patients scheduled at the infusion center?

Patients are referred by their gastroenterologist. The infusion center and your IBD case manager will collaborate with your schedule and your gastroenterologist to tailor the best course of therapy.

What will I need to bring on my first infusion?

If you have changed or updated your health insurance information, please bring your most current insurance card(s) and medication/allergy list.  You may also want to bring a book, iPod, crafts, or computer to pass the time.

How long does infusion therapy last?

The length of time for therapy is determined by the medication prescribed.  Most infusion therapies take approximately three hours. We do our best to make your visit as comfortable and as efficient as possible.

Will my insurance pay for infusion therapy?

Our on-site financial counselor and your case manager will work with you and your health insurance provider to make decisions about your plan of care.

How do I receive my prep and information packet?

Your packet of information will be mailed to you.  However, if you have not received your packet, printable information is available on our website.  You should also contact your pharmacy to ensure your prep medication prescription (if applicable) has been received.  If you are unsure how to take your prep, this information is also available on our website.  Of course, our office is available at (402) 397-7057 or (402) 504-3880 during regular business hours to answer prep and procedure questions.

Can I have pop, hard candies, coffee, or smoke while taking my prep?

Hard candies are acceptable, but avoid the colors Red, Blue, or Purple.  Orange is an acceptable color additive and can be consumed prior to your procedure.

Pop and coffee are also acceptable the day before your procedure.  Keep in mind pop should NOT be Red, Blue, or Purple.  Coffee should be black; do not add cream or milk, as they are not a clear liquid.

We encourage patients stop smoking; however, you may smoke while taking your prep.  We request you do not smoke on the day of your procedure.

What if I feel I am going to vomit if I drink another glass of prep, OR, what if I start to vomit while drinking the prep? Do I have to drink all of my prep?

You should drink all of your prep.  If you are having difficulty keeping your prep down, stop prep for 30-45 minutes until symptoms subside, and then resume.

What if I drink all of the prep and I do not have a bowel movement?

Wait one (1) hour.  If you continue to not have a bowel movement, you will need a Fleets enema.  This can be purchased over-the-counter at any pharmacy.  Following the enema, if there are no results, call the physician who will be performing your colonoscopy for further instructions.

What if I have rectal discomfort?

You may apply a petroleum based product or diaper rash ointment to the rectal area if you experience discomfort from frequent stools.

Will I be asleep for my procedure?

In the procedure room an anesthesia provider will position you comfortably and give you medications through an IV, known as MAC anesthesia, to cause relaxation and sedation.  This will cause you to fall asleep but you can breathe on your own and will wake up quickly.  Based on your individual procedure and medical history you and your GI physician may determine to use an anesthetic known as moderate sedation (twilight sedation) or even no sedation at all, as appropriate.

What should I bring on the day of my procedure?
  • Completed forms from Midwest Endoscopy Services, Lakeside Endoscopy Center or Methodist Endoscopy Center, if applicable.
  • The first and last name of all healthcare providers you would like your procedure report sent to.
  • Someone to drive you home.  Sedation is usually given during your procedure.  If you do not have a driver arranged, your procedure may be cancelled.
  • Photo ID (Driver’s License, Military ID, etc.)
  • All Insurance Cards (Medicare, Medicaid, Blue Cross & Blue Shield, etc.)
  • Insurance co-pay or required pre-payment
  • Many insurance carriers and managed care organizations require pre-authorization or pre-certification.  To obtain coverage for these procedures, we recommend you contact your insurance company.
What should I wear the day of my procedure?

Wear comfortable, loose fitting clothing.  Wear flat shoes or tennis shoes.  Please leave jewelry and valuables at home.

Why do I have to split my prep?

Recent studies have clearly shown split-dose preparation results in higher quality examinations with increased detection of precancerous polyps.

When was my last colonoscopy or upper endoscopy?

Please contact our office at (402) 397-7057 or (402) 504-3880 during regular business hours and our nursing staff will be able to assist you.  Our office will also mail you a reminder card when your procedure or office visit is due.

How do I get an office visit or procedure scheduled? Or how do I reschedule an appointment?

Our schedulers are available by phone from 8:00 a.m. to 4:30 p.m., Monday through Friday to schedule office visits or procedures by calling (402) 397-7057 or (402) 504-3880.  If you are unable to make your scheduled appointment, please call our office as soon as possible. We do request a 48-hour notice for all cancelations.

When I speak to a scheduler, what information will I need available to answer the scheduling questions?
  1. Insurance card(s)
  2. Medication list (names & dosages)
  3. Allergy list
  4. Name & number of your  primary care physician &/or referring physician
  5. List of past medical history (i.e. surgeries, endoscopies, & health concerns)
Where are you located and how can I find your office?

Our main office is located in the Mitchell Medical Plaza, directly south of the Walgreen’s on 90th & Dodge.  Click here for address and map for this location.

We also have an office conveniently located near Lakeside Hospital.  This office is located in the Lakeside Medical Plaza, between the Walgreen’s and Arbor Bank on 170th & Center.  Click here for address and map of this location.

What do I need to bring to my office visit?

1.  Completed Patient Registration Packet (mailed or see Forms tab) to include:

  • Medical information pertaining to your visit
  • Pertinent information about your medical and surgical history
  • List of your prescriptions, over-the-counter or herbal medications including doses
  • Pertinent Lab results (urine cultures, PSA, blood work, etc.)
  • Pertinent X-ray reports
  • Referrals or Pre-authorizations, if required by your Insurance

2. Photo ID (Driver’s License, Military ID, etc.)

3. All Insurance Cards (Medicare, Medicaid, Blue Cross & Blue Shield, etc.)

4. Insurance co-pay or required pre-payment

Why Quality and Safety Matters?

Not all GI examinations and procedures have equivalent quality.  To assist you in understanding the differences, we recommend you use the following guidelines when selecting a physician and/or facility to perform your procedure:

  • Your physician should be a fellowship trained Gastroenterologist
  • He/she should be Board Certified or Board Eligible in Gastroenterology
  • For your safety, the facility should be Medicare and Joint Commission or AAAHC accredited
  • Your physician should be able to discuss with you the number of times they have performed your specific procedure to include their individual quality data or outcome measures (i.e. complication rates, polyp detection rates, patient satisfaction) in comparison to national standards
Our Quality

Midwest Gastrointestinal Associates, PC (MGI) & Midwest Endoscopy Services, LLC (MES) have a recognized Quality Program.  Our quality is measured and demonstrated through our patient satisfaction scores, continuous clinical performance monitoring, medical outcomes, and receipt of major accreditations, designations and awards.

The purpose of our program is to facilitate a comprehensive review of the organization’s systems and functions as they impact our customers.  We continuously strive to provide health care services and education which consistently meet or exceed the expectations of patients, physicians, employees, and the community.

Our program’s objective is to identify opportunities for expense reduction, while simultaneously ensuring access to new technology, positive procedural outcomes, and patient satisfaction.  The effort includes a critical evaluation of our current practice to develop process improvements, reduce practice variation, and optimize resource consumption. We break down a process into a series of steps and then analyze them to decide how we can improve.  The effectiveness of our interventions is examined in terms of specific clinical and economical outcomes.  Our program consists of a collaborative and interdisciplinary approach by utilizing specialized and experienced Board Certified Gastroenterologists, Registered Nurses, Case Managers, Administrators, and a Dietitian to review and improve:

  • Health Promotion
  • Availability
  • Effectiveness
  • Timeliness
  • Complication Prevention
  • Efficiency
  • Customer Satisfaction
  • Ancillary/Support Services
  • Vaccination Program
  • Infection Prevention
  • Education & Training
  • Financial Control
  • Information Services
  • Medical Staff
  • Nursing Services
  • Environment of Care
  • Resource Utilization
  • Safety/Risk Management
You Are Safe Here

You may have read or seen on television the distressing results of a government study concerning infection control in ambulatory outpatient centers.  It revealed high percentages of Ambulatory Surgical Centers with breakdowns in their infection control measures potentially placing patients at risk.  The government has suggested Ambulatory Surgical Centers be subject to the same infection control measures hospitals are required to follow.

We are very proud to inform you that Midwest Endoscopy Services, LLC, is licensed by the State of Nebraska and accredited by The Joint Commission, Medicare and the American Society for Gastrointestinal Endoscopy (ASGE).  These are the same organizations that accredit hospitals.  Our policies, procedures and practices for infection control meet all standards set for hospitals.  We want to assure you that you are safe here and we continually strive to provide the highest quality patient care.

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