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Patient Forms, Insurance/Billing

New Patient Forms

Patient Information English Spanish
Health History English Spanish
Patient Consent Form English Spanish
Policy Agreement English Spanish
Patient Record of Disclosures English Spanish

Referal Form

Procedure Consent Forms

Capsule Endoscopy English Spanish
Colonoscopy English Spanish

Procedure Preparation Instructions

Colonoscopy English Spanish
Upper Endoscopy / Upper Endoscopic Ultrasound English Spanish
Sigmoidoscopy / Lower Endoscopic Ultrasound English Spanish
Capsule Endoscopy English Spanish
Clear Liquid Diet English Spanish
EGD Instructions 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
  • Vantage Health Insurance
  • Molina Health Insurance

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.

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