Digestive Health Associates

Southwest Endoscopy Center

Health Plans


Private Health Plans and Networks

Our participation in these plans is defined by the terms of our participation agreement.  Please contact your health plan directly regarding questions concerning your level of covered benefits or the manner in which the plan determines eligibility for or payment for a particulary medical service.

Anthem Blue Cross and Blue Shield (Colorado)
BlueCross BlueShield of New Mexico
CIGNA
Durango Network
Lovelace Health Plan
Pacificare
Presbyterian Healthcare Services
Rocky Mountain Health Plans
Sloans Lake/Cofinity
Southwest HealthNet
UnitedHealthcare





Narrow Network Health Plans
"Narrow network" plans contract with a limited number of providers and facilities.  Patients who choose a narrow network health plan accept reduced choice in return for a reduced premium.  Narrow network plans providing coverage in 2015 to La Plata County residents include the following.  This information is subject to change.

Anthem Blue Priority and Mountain Enhanced networks
Digestive Health - Southwest Endoscopy ARE participating

 


Government-Public Health Plans

Digestive Health Associates, PC is a private office-based medical practice.  Our capacity to provide care under government-sponsored health plans is limited.  Our participation in these plans is defined by the terms of our participation agreements.  Please contact your government health plan directly regarding questions concerning your level of covered benefits or the manner in which the plan determines eligibility for or payment for a particular medical service.





Our Current Public Plan Status

We are participating providers for Medicare, Champus (Tricare)/ChampVA, and Colorado Medicaid.

At this time we are not accepting new Medicaid patients.




Champus (Tricare) and ChampVA.  Our capacity to accept new Champus patients is limited.  

Colorado Medicaid.  We do not participate in out-of-state Medicaid plans.  At this time we are not accepting new Medicaid patients.  

Medicare.  Our capacity to accept new Medicare patients is limited.  Please contact the Medicare program directly at 
800.633.4227 for assistance with Medicare benefits.

Please be aware that information reported on Medicare's Physician Compare web site is inaccurate.  We recommend that all information reported on this site be independently verified directly with your physician's office.  The unreliability of this site is a national problem that is known to the Center for Medicare and Medicaid Services (CMS).
Download Medicare & You 2012  |  Medicare Contact Information


Other Health Plans


In some cases, depending on network agreements between plans and your own coverage, in-network benefits may also be available for the following carriers and plans.  It is critical however that you verify the specific details of Digestive Health's relationship with these plans before your care is rendered:

Aetna
GEHA
Great West
HMN
Multiplan



Plans contracted with Digestive Health are also contracted with the
Southwest Endoscopy Center, which is a licensed ambulatory surgery center that is required by law to function as an independent entity and bill separately for its services. 

Other entities with which we are affiliated or partner with in your care, such as Mercy Regional Medical Center, Southwest Diagnostic Laboratories, PC (our pathologist's private practice located at Mercy Regional Medical Center) and Animas Anesthesia Associates, LLC (our anesthesia provider at the Southwest Endoscopy Center), may not contract with the same plans.

If you have a plan which is not listed above please contact our facility administrator, Ms. Marianne Sloan, with regard to the possibility of initiating contracting discussions with your insurer.  It is important to let your insurance company representative know that it does not have a complete network of providers.  Insist that they add gastroenterology services for Southwest Colorado to their provider network.


Please call us if you have any questions regarding our insurance plan participation. 



Limitation in our acceptance of new patients based on health status
At this time we are not accepting new patients who require services that exceed the scope of our licensure as a Colorado Ambulatory Surgical Center (ASC).  This restriction is necessary because of limitations in our access to appointment slots at Centura Mercy Regional Medical Center's hospital outpatient department (HOPD).  Endoscopy patients who fail to meet medical criteria for admission to an ASC must have their appointments scheduled at a HOPD.  We are unable to accept new HOPD patients for whom we cannot provide care in a timely manner.