Resources for Patients

Laboratory Studies

DO NOT LOSE the lab script given to you.

Are these labs covered by insurance?

The only way to know what is covered, is for you to call your insurance carrier directly, and provide the diagnosis codes and CPT codes indicated on your lab script. The doctors order the lab tests they deem relevant. We do not know what tests your insurance will cover. We recommend getting a reference number from the agent before you hang up.

Appointments

Do I need a referral for my visit?

Call your insurance carrier’s customer service department to check the status of your referrals.

Why do I have to provide insurance information and verify my medications at every visit?

We are committed to providing you with the best medical care possible, and this requires having a complete understanding of all your current medications and treatments. If a medication was added or removed by a physician at another practice, we may not have been informed. We appreciate this can be frustrating, and we work hard to make your process as simple as possible.

What information should I bring to my office appointment?

• Medication list
• Insurance card/information
• Insurance copay, if required
• Completed forms

Will I need to wait to see the physician?

Gastroenterologists take care of a variety of different conditions. Some of these conditions require urgent or emergency attention. Occasionally this can delay or interfere with an office visit. Please understand we will do our best to notify you of a delay and do our best to be on time. We understand your time is valuable.

Does your office participate with my insurance carrier?

Check our list of participating insurance carriers.

Billing questions

For questions regarding your patient balance contact our billing department at 732-702-1039

When will my medication refill be called in?

Refills are handled as quickly as possible. New medications and those refills requiring authorization by your insurance plan will require additional time. If leaving a message with your refill request, please leave you name, date of birth, medication, dosage and frequency. In addition, please confirm your pharmacy.

Why haven’t I received my paperwork?

We send your paperwork out the day you are scheduled. We have no control over the postal service. If you haven’t received your paperwork (2) weeks after speaking with us, please call our office. Instructions can be found the website under “patient forms”.

Colonoscopy

From a billing standpoint, what is the difference between a screening colonoscopy and a diagnostic colonoscopy?

If your colonoscopy has been scheduled for a screening (i.e., you have no symptoms with your bowels*), and your doctor finds a polyp or tissue that has to be removed during the procedure, this colonoscopy could no longer be considered a screening procedure. It may be considered a surgical procedure and your insurance benefits may change. It is your responsibility to check with your insurance company prior to your procedure date to assure that you understand your insurance benefits and coverage.

*Symptoms such as change in bowel habits, diarrhea, constipation, bleeding, anemia etc.

Can I change my procedure time?

Procedure times are scheduled by the facility. Diabetics generally go first. Procedure times cannot be changed.

Why can’t I drive myself home?

You will not be able to have sedation if you come to the facility without transportation home by a responsible adult. This is for your safety. After your test you will be under the influence of sedatives and narcotics, and this is very similar to being drunk. Even if you feel fine, you will not be allowed to drive yourself home. Your judgment and reflexes will be compromised by the drugs. You will not be allowed to take a taxi, bus or Uber unless accompanied by a responsible adult. You may not walk home after the procedure. If you have not made arrangements for a ride, we will cancel your procedure. If you want to have your test without sedation, you can drive yourself home.

Can I do a pill prep?

No. Our experience with tens of thousands of patients over the years has shown that the pill prep does not work as well as the standard liquid prep. Pill prep has not been studied/validated in clinical trials and there have been concerns over their safety. Often pill prep leads to suboptimal exams, or incomplete exams, requiring a repeat colonoscopy. We value your time and that of your family/friends who will bring you to your appointment. Our goal is to make sure your colonoscopy exam is of the highest quality, and also to avoid unnecessary repeat procedures.

What about Cologuard?

Physicians regard colonoscopy as the gold standard. Colonoscopy has the highest detection rate of small tumors and polyps, and It is the cancer screening that can prevent colon cancer by removing precancerous polyps. It’s also important to remember that most insurance companies will only cover one colon cancer screening test. If a stool-based test is positive, the follow-up colonoscopy may be considered diagnostic and fall under the patient’s deductible. This is important to know because the false positive rate (test coming back positive when everything is completely normal) is about 13%. In addition, 8% of patients with cancer received a negative result (false negative)

I’ve heard some things about virtual colonoscopy. How does it compare to conventional colonoscopy?

If your physician finds a polyp when he or she is doing your colonoscopy, it can most often be removed at the time. A virtual colonoscopy is an imaging test that uses x-rays and computers. If a polyp or other abnormality is discovered in a virtual colonoscopy, the patient needs to return for another procedure, a colonoscopy, so that the polyp or polyps can be removed.

Why do I have to take the laxatives at different times?

Different laxatives take different amounts of time before they work. Your doctor has performed many of these tests, he/she knows what works and how much needs to be taken in order to get the colon thoroughly cleaned out. Take all of the prep ordered for you. Do not discontinue prepping because you think you are cleaned out enough without speaking to your doctor.

What is a clear liquid?

Allowed: water, black coffee, tea, clear fruit juices, soda, Gatorade, broth, popsicles, and JELL-O. Not allowed: any red liquids, alcohol, milk, creamers, juices with pulp (orange juice).

Why avoid red liquids?

The red color can persist in the colon and potentially look like blood.

Can I drink alcoholic beverages?

We strongly suggest you do not drink any alcoholic beverages prior to your procedure since they can cause dehydration and some wines may thin your blood.

Why do I have to drink so much liquid during the preparation?

The laxatives you will take use the fluids you drink to help move stool through the colon. If you don’t drink enough fluid, your colon uses the fluid from within your body. This can cause dehydration. It is very important to drink at least as much fluid as your preparation instructions tell you to. If you start feeling nauseous, jittery, or faint during your preparation, it is most likely because you aren’t drinking enough fluid. Staying hydrated helps you to tolerate the prep better.

What should I do if I get low blood sugar?

You can have sweetened drinks during prep even if you are diabetic. This includes Popsicles, JELL-O, juice, and soda. These are all fine to drink and considered clear liquids.

I feel nauseous. What should I do?

You can take a short break from drinking the prep. Try drinking ginger ale or another clear liquid to help settle your stomach. Continue your prep when the feeling has subsided. Try drinking the prep through a straw and also chilling the prep. You may also slow down how fast you are drinking the prep.

My prep made me throw up. What should I do?

Some people do get nauseous or may even throw up the prep. If that happens, stop drinking the prep for 1 hour and restart more slowly. If you throw up again or still feel sick, you must call our office for instructions.

Can I come for my colonoscopy if I have a cold?

Yes, you can come in for your procedure. Please reschedule if you have a fever >100.4°F, are feeling very ill, or have trouble breathing.

I take antibiotics before my dental procedures because of a heart murmur. Will I need them before the procedure?

No, the American Heart Association does not recommend antibiotic prophylaxis in patients undergoing gastrointestinal procedures

Can I take herbal supplements before the procedure?

You should stop taking iron, vitamins or herbal supplements 7 days before your procedure.

My bottom is sore and itchy. May I use something for this?

Yes, you may use any hemorrhoid remedy such as Preparation H or Tucks Medicated Pads. Vaseline or diaper rash creams may prevent chafing and tender skin. You may reapply as needed.

What should the end result of the preparation look like?

Whatever is coming out of the colon near the time of your test needs to be liquid and we need to be able to see through it. That means, if you were to drop a penny in the toilet, you would be able to see it. Little flecks of sediment are okay. A yellow or orange color is expected. Your gastroenterologist can do some washing and suctioning of liquid from the colon, but if the colon is not cleaned out enough, polyps can be missed. If a preparation is not good, it takes longer to do the test. This can increase your procedure time, cause delays, and increase the amount of sedation you will require. You can help us keep you on time by following your preparation instructions. If you are still having solid or dark stool or are unable to tolerate your preparation, call us as soon as you can. We may ask you to change laxative or take an additional laxative.

Can I brush my teeth?

Yes, please do.

What medications am I able to take the morning of the procedure?

POSITIVELY NO TRANQUILIZERS, ANTI-DEPRESSANTS, SEDATIVES, SLEEPING OR PAIN MEDICATIONS. You can take heart, seizure and hypertension (except diuretics) medications with small sips of water two hours before the procedure. If you use any inhalers, bring them with you in case they are needed.

Can I wear my dentures?

Yes, you may wear your dentures to the endoscopy suite. However, you may be asked to remove them prior to the procedure.

What type of anesthesia/sedatives will I be given?

Propofol Anesthesia.

Can I proceed with my procedure while on my menstrual cycle?

Yes.

I am having a lot of pain and discomfort after my procedure?

You should call our office. If you are having severe pain, you should go to the emergency room.

When can I eat after my procedure?

Generally, you can eat immediately after your procedure avoiding greasy or spicy foods. Occasionally there is mild nausea from the sedative medications.

After the procedure, when will I have a normal bowel movement?

Because your intestines were completely cleaned out for your procedure, it may take a few days of eating solid foods before you have a bowel movement.

Medical Records

How can I obtain a copy of my medical records? Is there a fee?

Patients can obtain a copy of their medical records by completing and returning a record request form that is supplied by our office (also available on our website, under patient forms). After the completed form is received, the chart will be reviewed, copied and sent to the patient. There is no charge for your initial request for your records, however, subsequent requests will result in a charge of $1.00 per page copied.

I have relocated, or I have a new Primary Care Physician – how do I go about having a copy of my records sent to my new doctor?

Upon receipt of an acceptable record request form, filled out completely and signed by the patient, either supplied by our office or your new physician’s office, the chart will be reviewed, copied and then sent to the address indicated on the record request form.

My insurance company needs a copy of my medical records – how do I go about having a copy of my records sent to the insurance company?

Insurance companies have the proper request forms for patients to sign. After signing the form, your agent will send the form to our office along with the documentation stating what records are required. The chart will then be reviewed, copied and sent to the indicated address. There will be a charge of $1.00 per page for this service.