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Discrimination is Against the Law

Allied Digestive Health (“ADH”) complies with applicable Federal Civil Rights Laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ADH does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

ADH and its affiliated practices and departments:

Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats)
- Provides free language services to people whose primary language is not English, such as:
  - Qualified interpreters
  - Information written in other languages

If you need these services, contact:

Beverly Coleman, Chief Human Resources Officer and Privacy Officer and Civil Rights Coordinator
Allied Digestive Health
Monmouth Corporate Park 1
187 Highway 36, Suite 230
West Long Branch, New Jersey 07764
compliance@hcompliance.com
844-932-6675

If you believe that ADH or its affiliates has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with Beverly Coleman at the contact information above. You can file a grievance in person or by mail, fax, or email.

If you need help filing a grievance, you may also contact the Privacy Officer, Beverly Coleman, at the contact information listed above for assistance.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue SW Room 509F
HHH Building Washington, DC 20201
1-800-868-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Or you can file a Civil Rights complaint with the New Jersey Division on Civil Rights at the following locations:

Northern Regional Office

31 Clinton Street, 3rd Floor
Newark, NJ 07102
973-648-2700
Fax: 973-648-4405

Central Regional Office

140 East Front Street: 6th Floor
PO Box 090
Trenton, NJ 08625
609-292-4605
Fax: 609-984-3812

Southern Regional Office
5 Executive Campus, Suite 107
Cherry Hill, NJ 08034
856-486-4080
Fax: 856-486-2255

South Shore Regional Office
1325 Boardwalk, 1st Floor
Tennessee Ave & Boardwalk
Atlantic City, NJ 08401
609-441-3100

LANGUAGE ASSISTANCE SERVICES are available to you at ADH free of charge. To obtain services, call 844-932-6675.

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 844-932-6675.

Chinese: 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 (732) 222-3805 .

Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 844-932-6675.

French Creole: ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 844-932-6675.

French: ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 844-932-6675 (ATS : ).

Korean: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 844-932-6675 번으로 전화해 주십시오.

German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 844-932-6675.

Italian: ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 844-932-6675.

Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 844-932-6675 (телетайп: ).

Tagalog–Filipino: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 844-932-6675.

Polish: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 844-932-6675.

Portuguese: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 844-932-6675.

Japanese: 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。844-932-6675まで、お電話にてご連絡ください。

Hindi: ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 844-932-6675 पर कॉल करें।.

Punjabi: ਧਿਆਨ ਦਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। 844-932-6675 ‘ਤੇ ਕਾਲ ਕਰੋ।.

Gujarati: મહેરબાનીકરીનેનોંધકરો: જોતમેગુજરાતીબોલોછો, તોભાષાસહાયકસેવાઓમફતઆપવામાંઆવેછે. કૉલકરો 844-932-6675.

Arabic: يرجى ملاحظة: إذا كنت تتحدث العربية ، فإن خدمات دعم اللغة تقدم مجانًا. يتصل844-932-6675.

Urdu: دھیان دیں: اگر آپ اردو بولتے ہیں تو آپ کے لیے مفت لینگویج سپورٹ سروسز دستیاب ہیں۔ (732) 222-3805 پر کال کریں۔

Eff: June 7, 2022

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed

You have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

Check with your State Department of Insurance to determine if you have balance billing protections under state law.

If no state law applies or if you think you’ve been wrongly billed, contact the federal regulators responsible for enforcing the federal surprise billing protection laws at 1-800-985-3059.

Visit https://www.cms.gov/nosurprises/consumers for more information about your rights under federal law.

Shore Gastroenterology Associates can help with questions concerning billing. Contact us before hand if you have any concerns about the procedures we provide and coverage.

Your Rights and Protections Against Surprise Medical Bills

What is “balance billing” (sometimes called “surprise billing”)?

You are protected from balance billing for:

When balance billing isn’t allowed

Important Notice: Participating Carriers

We are pleased to inform you that our services are covered by a variety of participating insurance carriers. Please review the list of participating carriers to ensure your plan is included.

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Search Results for: https:/www.tempcontrolpack.com/de/knowledge/is-there-any-pollution-problem-with-ice-packs-2/about-us

Your Rights and Protections Against Surprise Medical Bills

What is “balance billing” (sometimes called “surprise billing”)?

You are protected from balance billing for:

When balance billing isn’t allowed

Important Notice: Participating Carriers

We are pleased to inform you that our services are covered by a variety of participating insurance carriers. Please review the list of participating carriers to ensure your plan is included.