What insurance plans do you accept?
We accept most major commercial plans and Medicare. Coverage varies by employer plan, even within the same insurance company. Always confirm your individual plan coverage with your insurer before your visit.

Do I need a referral to be seen?
It depends on your insurance plan.
1. HMO and Masshealth/Medicaid plans require an insurance-authorized referral from your primary care provider (PCP) in order to see a specialist doctor.
2. PPO/EPO/POS plans often do not require an insurance-authorized referral to see a specialist doctor.
3. Please call your insurer at the number listed on the back of your insurance card if you are not sure.

How do I obtain a referral?
If your insurance requires an authorized referral to see a specialist doctor, it is your responsibility to reach out to your primary care provider (PCP) to obtain one. An insurance-authorized referral must include all of the following 5 items:
1. Our Group NPI: 1710523147
2. Authorization Number
3. Number of Visits Authorized
4. Diagnosis Code
5. Start/End Date

Boston Specialists is committed to providing the best possible endoscopy experience, with an emphasis on safety, comfort, and convenience.

Experience

Dr. Leung has been doing endoscopies since 2007.

Unrivaled Convenience

Boston Specialists offers same week and month procedures, performed by the same gastroenterologist that you see for your regular consultations!

What is a deductible?
Your deductible is a set amount you must pay out-of-pocket each year before your insurance starts paying for covered services. It typically resets at the start of every calendar year.

Example:
If your deductible is $1,500 and you haven’t paid for any services towards that amount, you may be responsible for full visit and procedure costs until you reach $1,500.

What is a copay?
A copay is a fixed amount you pay for a visit or service. This amount is determined by your insurer and will be due at check-in. You may still owe a copay even after you meet your deductible.

What is coinsurance?
Some insurance plans may require you to pay a coinsurance, which is a percentage of the total cost of your visit or procedure. You may still owe a coinsurance even after you meet your deductible.

What is “out-of-pocket maximum”?
This is the most you’ll pay in a year for covered services. Once you reach this limit, your insurance pays 100% of covered services for the rest of the year.

What is Prior Authorization?
Some insurance plans require approval before certain services (e.g., endoscopy, biologic injections, infusions, advanced imaging, food challenges). Our office will request authorization, but approval is not guaranteed and is ultimately determined by your insurance. We ask that you be patient with our team, as prior authorizations can take up to 2 weeks to process.

Will I get a bill even if I have insurance?
Yes, you may receive a bill for a deductible, copay, coinsurance, or non-covered services. Insurance rarely covers 100% of costs unless you’ve met your out-of-pocket maximum.

When do I have to pay?
Copays and estimated patient responsibility are due at the time of service. Balances after insurance processes your claim will be billed later.

What if my insurance denies coverage?
You are responsible for the full cost of any visits or procedures if any of the following are true:
-You did not obtain a required referral or authorization
-Your plan is out-of-network
-Your plan considers a procedure as a non-covered service
We can provide documentation to assist with appeals, but payment responsibility remains with the patient. We recommend calling your insurance to check if proposed services are covered by your plan.

What if I’m out-of-network?
Out-of-network services often result in:
-Higher out-of-pocket costs
-Balance billing
-Denied coverage
Always confirm network status with your insurer before your appointment.

Important Note
Insurance coverage is a contract between you and your insurer. Final coverage decisions are made by your insurance company.

Will my procedure be covered?

Coverage will depend on the requirements of your insurance plan:
-In-network coverage
-Whether the procedure is considered preventive vs diagnostic
-Whether prior authorization is required
Examples:
Screening colonoscopy may be covered differently compared to a diagnostic colonoscopy

Is there a no-show/cancellation policy?
Any changes to the appointment must be made at least 7 days prior to the procedure date, outside of extenuating circumstances such as illness or inclement weather. If you cancel your procedure within 7 days of the procedure date or do not show up to the appointment, a cancelllation fee of $250 will be charged to your credit card on file.

What do I need to do to prepare for the clinic visit?

-Bring a photo ID and insurance card
-Identify a pharmacy that you will use for picking up medications (address and fax#)
-If you are here for allergy testing, see here
-If you are here for other specific tests, see here
-Find out your co-pay amount by calling your insurance company or checking your insurance card

Preparing for Your Appointment

After this time, your designated driver may bring you home. 10 days after your procedure, we will see you at our clinic for a follow-up visit to discuss the results of your endoscopy and pathology, as well as to form long-term treatment plans accordingly.