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Capsule Endoscopy Instructions
Your scheduled procedure will take place at WIMC at 3100 Blue Ridge Road, Suite 300. Please arrive 15 minutes before your scheduled time. Call 919-781-7500, ext. 281 (Ann) or ext. 278 (Debbie) if you have any questions. 1. The day before the procedure, eat a normal diet until 12 Noon. From 12 Noon until 8 p.m., you may have clear liquids only. NO RED JELL-O 2. NO Carafate, Mylanta, or Maalox for 24 hours prior to the procedure.
3. Drink 1 bottle of Magnesium Citrate at 7 p.m. the night before. (NO RED
MAGNESIUM CITRATE).
4. Starting 12 hours before procedure absolutely NOTHING to eat or drink. 5. NO Medications 12 hours before procedure. 6. NO Iron supplements 4 days before procedure. 7. NO smoking 24 hours before procedure. 8. Dress comfortably and wear two-piece clothing. 9. You may take your medications after your procedure. You will need to return at 4:15 p.m. to return the capsule Endoscopy equipment. We will download the images for a physician to review.
Please be aware that you should not have a MRI or be near a MRI device
until after you have passed the camera capsule through a bowel movement.



ALL COLONOSCOPY-SIGMOIDOSCOPY-GASTROCOPY PATIENTS
PRIOR INSURANCE APPROVAL
Some insurance companies require prior approval for these procedures done in the office. It is your responsibility to check with your insurance company for prior approval. If they require authorization, please call our office, (919) 781-7500 ext 281, with all pertinent information and we will obtain the authorization. Some insurance companies may not cover screening procedures. If your doctor has requested your procedure because you have reached the age where these procedures are recommended, you insurance company considers this a screening procedure. It is your responsibility to see how your insurance company will cover the procedure. For some outpatient procedures, insurance companies will cover at a percentage or copay different than they would for an office visit. WAKE INTERNAL MEDICINE PAYMENT POLICY
PAYMENT IS DUE AT THE TIME OF SERVICE
Wake Internal Medicine Consultants does require patients with Medicare and noncontracted
insurances to pay to pay your estimated cost of the procedure in full one week prior to services
being rendered. This is an estimated cost only and is subject to change in response to the
physician’s findings and subsequent treatment.
If you have Medicare your estimated cost will be based upon the current Medicare Limiting
Allowable, for all other plans your estimated cost will be based upon our current fee schedule. Our
office will submit a claim to your insurance company on your behalf. Your insurance company will
then remit their payment directly to you, the insured.
If you have insurance that is deductible, coinsurance, or copay the patient will be responsible to pay
the full amount prior to services being rendered. For example; if BCBS State is your insurance and
have not met your deductible of $350.00 you will be expected to pay up to $350.00. If you have met
your deductible you will be asked to pay a $150.00 down payment that is to offset the 20% patient
coinsurance.

We thank you for your patience and cooperation through the billing process and greatly appreciate
you choosing Wake Internal Medicine for your medical care. If you have any questions regarding
your fees please call (919) 781-7500 ext 324.
ALL COLONOSCOPY – UPER ENDOSCOPY PATIENTS

Because of the medication you receive, you may not remember the procedure or speaking with the
doctor afterwards. We encourage you to ask questions prior to the procedure and to call our office
afterward, should you have any questions. The doctor will discuss his findings with you after the
procedure. If biopsies or polyps were removed during the procedure, you should
receive a phone call regarding the findings within 5-7 business days. If you have not heard from our office about the pathology results within 7-10 business days, please call.

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