We welcome you to Southern Gastroenterology Associates. To make an appointment with our specialists, please call our office at 434.572.8196 or make an appointment online. Our scheduling coordinators are ready to assist you. We look forward to meeting you on your appointment day and thank you for the opportunity to serve your needs.
Please provide your name, date of birth, telephone number, type of insurance and reason for your visit. You are asked to bring your insurance cards, copayment along with medications and dosages that you are taking. If you have any medical records that may help with your care, please bring them with you to your appointment. If your insurance requires a referral from your primary care doctor authorizing your visit, you will need to make sure this has been done prior to your appointment.
Please fill out the necessary paperwork before your appointment. This will save time when you arrive at the office. The first form is a registration form verifying your personal information. The second form is the (HIPPA) Health Insurance Portability and Accountability Act. Another very important form is Health History. This is usually very detailed and will take some time to fill out. We also have a financial policy that you will need to review, sign and date. Please bring a photo i.d., your insurance, and prescription drug cards along with all of your medications with dosages and any co-pays due.
You can bring the filled out forms with you to your appointment, or you can fax them to 434.572.8341 prior to your appointment time.
Important: Note that patients not seen in our office within the past 3 years are considered new patients.
Required Form Packet
PATIENT REGISTRATION & REQUIRED COMPLIANCE FORMS | ![]() |
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Make an appointment online. Fill out our form and a scheduling coordinator will contact you to confirm your appointment. |
Billing & Insurance
We participate with most insurance companies for patients age 16 and up. Our office staff makes every effort to be well informed regarding insurance; however, it is your responsibility to be familiar with your particular policy. Please check prior to your appointment if your physician is in your network or if you have any pre-existing conditions on your policy (see below). If your insurance requires an insurance referral from your primary care physician, it is your responsibility to obtain that referral. If you do not provide us with a referral, you are assuming responsibility for payment of that visit. If you do not have insurance, please contact our office prior to your appointment for payment options.
Copays are due at time of service. We accept cash, checks, Visa, Master Card, Discover and American Express. You will receive a bill for the balance due after an insurance payment, which will be due upon receipt. If your account goes to a collection agency, you will be responsible for all costs of collections.
What is a pre-existing condition exclusion period?
A pre-existing condition exclusion period is a period of time during which your insurer is not obligated to pay claims related to your pre-existing condition. A pre-existing condition is a medical condition for which medical advice, diagnosis, care or treatment was recommended or received within the 6-month period before your enrollment date in an employer’s group plan.
Our office checks to see if prior authorization is required for outpatient procedures and x-rays. Please check your benefits prior to having a colonoscopy, endoscopy or any testing done. Your insurance benefits may vary (some insurance policies only cover if done in an office setting). Ask what your benefits are for a procedure performed in a physician office versus an outpatient hospital setting or ambulatory surgical center. All of our procedures, x-rays and laboratory studies are done at Sentara Halifax Regional Hospital on an outpatient basis. Ask if Sentara Halifax Regional Hospital is in your network.
If you are having a colonoscopy, know what type of colonoscopy you are having. A screening colonoscopy is performed for screening only and there is no medical diagnosis. A diagnostic colonoscopy is performed for a medical problem or diagnosis. Ask what your benefits are for a screening colonoscopy versus a diagnostic colonoscopy. Even if you are scheduled for a screening colonoscopy, if your doctor removes a polyp or takes a biopsy, some insurance companies will no longer recognize this as a screening colonoscopy.
Please be aware when your doctor performs a procedure, you may receive bills from multiple providers. There will be professional fees (doctor charges), facility charges (hospital fees), and possible anesthesia and pathology charges.
We participate in the following insurance:
MEDICARE
ANTHEM
PRIMARY PHYSICIAN CARE
SOUTHERN HEALTH
MEDICAID IN VA – OPTIMA, HEALTHKEEPERS PLUS, VA PREMIERE { not out-of-state Medicaid }
UNITED HEALTHCARE
CIGNA
VA HEALTH NETWORK
HUMANA
AETNA
We advise patients to check with their individual plan for coverage and benefits.