Patient Forms, Insurance/Billing

New Patient Forms

Patient Information	English	Spanish
Health History	English	Spanish
"No Show" Policy	English	Spanish
Acknowledgement	English	Spanish

Patient Record of Disclosures

Referal Form

Procedure Consent Forms

Capsule Endoscopy	English	Spanish
Colonoscopy	English	Spanish

Procedure Preparation Instructions

Colonoscopy	English	Spanish
Upper Endoscopy	English	Spanish
Capsule Endoscopy	English	Spanish
Diet Explanation	English	Spanish

Insurance / Billing

We accommodate cash patients in addition to a large number of insurance carriers in San Diego.

A partial list includes:

We are contracted with most PPO plans. 

HMO's
Mercy Physicians Services Health Plans

• Aetna
• Anthem Blue Cross Commerical
• Anthem Blue Cross Senior Secure
• Blue Shield Commerical
• Health Net Seniority Plus
• PacifiCare Commerical
• Scan Senior
• Secure Horizons

San Diego Physicians Services

• Aetna
• Blue Cross/California Care
• CHG
• Great-West Healthcare
• Pacificare

Multi-Culture

• Senior Plans
• Commerical Plans

Government Payers

• Medicare
• Medi-Cal

Our billing/insurance department is available to answer your questions from 8:30 a.m. until 5:30 p.m. Monday through Friday by dialing (619) 425-2737 or via fax to 619-425-5869.

If you find it more convenient than paying by check, you may pay your bill using your Visa, MasterCard, American Express, Discover and ATM.