Frequently Asked Questions

Do you have a question? Chances are that other patients have asked us about similar topics, so we've compiled a list of those most frequently asked, (FAQs), to help you answer yours.

Center for Digestive Health & Nutrition (CDHN)

What is the Center for Digestive Health & Nutrition?
The Center for Digestive Health & Nutrition, (CDHN), is a private medical practice of seven experienced Gastroenterologists, Nurse Practitioners, and staff, dedicated to the prevention and treatment of digestive disorders. Our physicians have been serving the needs of those in Western Pennsylvania and surrounding areas since 1977, having cared for tens of thousands of individuals with digestive problems. Our medical staff has over 200 years of collective experience in treating digestive disorders and is available to help those in need.

Where is CDHN located?
CDHN is conveniently located at 725 Cherrington Parkway, Moon Township, PA 15108, a pleasant suburban setting north of Pittsburgh, PA. There is ample, on-site free parking for patients and their families. CDHN shares the first floor of this medical building with a surgical center devoted to gastrointestinal procedures: the Three Rivers Endoscopy Center, (TREC), where most of our outpatient endoscopy "scope" procedures are performed.

What conditions to you treat?
Our team employs cutting-edge technology to diagnose and/or treat all digestive conditions including colon cancer, colon polyps, heartburn, acid reflux, celiac disease, swallowing problems, digestive bleeding, stomach ulcers, chronic indigestion, liver disease, hepatitis, gallstones, diseases of the pancreas, irritable bowel syndrome, ulcerative colitis, Crohn's disease, internal hemorrhoids, persistent nausea/vomiting, weight loss, gas and bloating, abdominal pain, chronic constipation, and diarrhea.

We do not perform surgery. Our focus is concentrated on diagnosis and medical treatment. We are all highly trained, and experienced in both endoscopic examination of the stomach, (gastroscopy), and colon, (colonoscopy). For the treatment of internal hemorrhoids, we have had great success with the O'Regan Hemorrhoidal Ligation procedure, and since 2005, we have offered the option of the amazing “camera in a pill” PillCam™ procedure to enhance the views of the small intestine.

Do I need a referral to visit CDHN?
This depends on your insurance provider, and insurance plan. Please contact your provider for details about your coverage.


How long will it take to get an appointment?
Gastroenterology is a specialty practice, and unlike primary care providers, routine appointments may take several weeks. For emergencies, we set aside a number of openings each day in our schedule.

Can I register for an appointment online?
Yes. You can schedule an office visit to one of our providers, and complete most of the required paperwork when you book an appointment online, helping us make your visit more efficient, and saving you time. An endoscopic "scope" test can begin online, but our appointment staff will need to contact you to finalize the details, and provide any necessary preparative instructions. To schedule online, visit our website, www.gihealth.com.

Do you treat children?
Our physicians treat patients who are 16 years old, or older. Children under age 16 should be seen by a pediatric gastroenterologist. Our endoscopy center, TREC, only accepts patients over 18 years of age. Younger patients who need an outpatient endoscopic procedure are scheduled at a local hospital surgery center.

Does CDHN handle Workers' Compensation claims?
No, CDHN does not handle Workman's Compensation claims.

Will my doctor receive updates on my care?
Coordination of care is a very important part of a specialty consultation. Physicians often refer patients to us concerning a specific digestive problem. Depending on the type of problem, we may initiate diagnostic studies or treatment. Most patients will continue to be cared for by their primary physician after a diagnosis and treatment plan has been established. Under certain conditions, we may also continue to monitor your gastrointestinal problems. Your personal physician will receive a comprehensive report, with recommendations, usually transmitted before you leave our facility by our computerized Allscripts Professional Electronic Health Record (EHR) system and ProVation® MD computerized endoscopy record system.

Which hospitals do your physicians attend?
Our physicians provide inpatient gastroenterology consultations, and perform inpatient and outpatient procedures at Heritage Valley - Sewickley Campus, and Heritage Valley - Kennedy Campus (formerly Ohio Valley General Hospital). However, the majority of our outpatient endoscopic procedures are performed at our endoscopy center, Three Rivers Endoscopy Center, which is conveniently located in the same facility as our outpatient medical practice.

Three Rivers Endoscopy Center

In 1996, the Three Rivers Endoscopy Center, (TREC), was constructed in Moon Township to provide an efficient, convenient, and affordable option for patients in need of endoscopic, or “scope,” procedures. Three Rivers Endoscopy Center was the first freestanding ambulatory surgery center in Western Pennsylvania solely dedicated to gastrointestinal endoscopy. TREC is a member of the American Association of Ambulatory Surgery Centers, fully certified by the Pennsylvania Department of Health, and approved as a Medicare and Medicaid provider. We are proud to add that Three Rivers Endoscopy Center has been licensed by the Accreditation Association for Ambulatory Health Care (AAAHC) since 1996. TREC was the first endoscopy center in Western Pennsylvania to achieve this endorsement.

Why do you perform procedures at Three Rivers Endoscopy Center (TREC) rather than the hospital?
Specializing in gastroenterology and endoscopy procedures, TREC was specifically designed with efficiency, patient convenience in mind.

TREC specializes in gastroenterology and endoscopy procedures, and was designed with efficiency, patient convenience, and simplicity in mind. Our staff members are specifically trained in GI procedures, and our team of highly skilled doctors and nurses are committed to providing the highest quality endoscopic services in a controlled, comfortable environment. Our physician-directed, patient-focused approach is intended to promote your long-term GI health, resulting in a high degree of patient satisfaction.

Benefits of an Ambulatory Endoscopy Center:
The benefits of having your procedure performed at TREC:

  • Endoscopy is performed by a trained Gastroenterologist, assuring you of quality, personalized care.
  • Endoscopy is more economical at TREC, because the overhead costs are lower than those of a hospital. The average charge for treatment here is about 50% less than having the same procedure at a hospital surgery center. In an era of increased copays and deductibles, this is especially significant for our patients.
  • Simplified admitting and discharge procedures ensure convenience for the patient. Free onsite parking.
  • A patient's family can relax in our center's calm waiting area.
  • Realizing that each case is unique, we provide close, personal attention at all times.

What procedures do you perform?

  • Colonoscopy
  • Flexible Sigmoidoscopy
  • Removing colon polyps
  • EGD (esophagastrodudonoscopy),
  • Esophageal Dilation
  • Endoscopic Retrograde Cholangiopancreatography (ERCP) at local hospital X-ray department
  • Capsule Endoscopy or "Pill Cam"
  • Percutaneous Endoscopic Gastrostomy (PEG Feeding tube) at local hospital surgery department
  • Infusion Services for inflammatory bowel disease
  • Breath Testing for H. pylori, the "ulcer bacteria"

Do I need a screening/consultation before scheduling a colonoscopy?
That depends. Every case is unique. If you are a new patient, you will probably need to visit our office prior to scheduling a colonoscopy. Our physician or Nurse Practitioner will perform a history and physical to assure that you are healthy and have no medical problems that may hinder the safety of the procedure. If you have no digestive symptoms, but need a screening exam, we often just review your family doctor's last evaluation. Further details may be necessary, and will be requested during a phone call. In general, returning patients who have been treated in the recent past do not need a preoperative office visit unless their health status has changed.

Can I register for a "scope test" online?
Yes. Scheduling an endoscopic procedure (Gastroscopy or Colonoscopy) can begin online, but our appointment staff will need to contact you to finalize the appointment details and provide any necessary preparative instructions.

Does a colonoscopy indicate whether I have colon cancer?
Yes. A colonoscopy is recognized as the most accurate way to determine the health of your colon. During this procedure, we check for cancer, polyps, colitis, diverticulosis, and other less common lower digestive problems. Even more importantly, a colonoscopy can help prevent colon cancer by effective detection and removal of precancerous polyps.

Should I bring a family member or friend to my procedure?
Yes. Someone over the age of 18 with whom the doctor can discuss the findings of the procedure, with your permission to do so, as you may not remember what you are told due to the effects of any medications you received. The person you bring will also be responsible for driving you home, or accompanying you if you take a taxi home.

Questions about preparation

What is bowel prep and why do I need one?
For your gastroenterologist to have a clear picture of the inside wall of your colon, it is extremely important for the colon to be completely cleaned out. Problems can arise, if the colon is not thoroughly prepared using our recommended bowel preparation and following the instructions very carefully and completely. A colonoscopy is safe and accurate when performed by an experienced doctor, qualified support staff, state-of-the art instruments, anesthesia AND A CLEAN COLON! For a successful outcome, we strongly emphasize the importance of a "clean" colon. The colon prep is a type of laxative that induces the colon to empty all of its contents, thus allowing the physician to clearly see all of the tissue.

Can I take pills for bowel prep?
Yes you can! A major complaint with past preparations for a colonoscopy has been the bad taste of the prep solutions. Now we have SUTAB, a new pill preparation that became available in early 2021. It is not "a pill," but 24 pills. The night before your colonoscopy exam, take 12 pills over a period of about 20 minutes with a lot of water. Repeat the process about 6 hours prior to the exam, on the morning of your colonoscopy. The pills are about the size of a large vitamin capsule.

Why can't I take all of the prep solution the night before my exam?
In the past, preps for a colonoscopy were give the night before the examination. The colon was nice and clean when the patient went to bed, but problems arose overnight as bile and mucous in the small intestine entered the right side of the colon and covered the lining, making the test far less accurate. By cleaning out the colon the night before and the "polishing it" again 6 hours before the examination, the right side of the colon is almost always suitably prepared. Gastroenterologists in the US switched to this, so called, "split prep" a few years ago.

What if I start vomiting while drinking the solution?
If you develop symptoms of nausea or vomiting, stop the prep for 30 minutes, then resume the process. Go slower by drinking one 8 oz. glass every 30 minutes instead of every 15 minutes. Cool down the prep in the refrigerator, or in an ice bath, before drinking it. If you were not able to complete the prep, please call us at (412) 262-1000 and speak with our nurse, or doctor on night call.

What will happen if I eat or drink something right before (or a few hours before) my procedure?
Your procedure will probably be cancelled. It is dangerous to receive sedation if you have had something to eat or drink before your procedure. Our first concern is your health and safety. Sedatives administered prior to your procedure, affect your body's ability to retain food and liquid in your stomach. If you eat or drink several before your procedure, there is a risk that food or liquid will travel up into your esophagus, where it could enter your lungs. Your procedure will be re-scheduled if you do not follow the instructions provided by your doctor. You must be totally fasting for four (4) hours before your procedure, eat nothing!

How do I know when my bowel prep is complete?
The stool output should look similar to the liquids that you are drinking, clear, without any particles.

I finished my colonoscopy prep and I am not sure my preparation worked. What should I do?
A normal sign of success in your preparation, is passing clear or yellow colored fluid from your rectum after following the procedure for the bowel preparation. If, on completion, you are still passing formed stool, your procedure may have to be rescheduled. To determine the next step, contact us as soon as possible and request to speak with a nurse or our doctor on night call.

Do I have to drink all the solution to cleanse my colon?
You are encouraged to carefully follow all the instructions for using the prep, so please make every effort to drink all of the solution. Purging a colon is not influenced by the height and weight of a patient. Remember, you are trying to clean out your entire digestive tract. If your colon is not clean, the physician cannot perform a thorough exam. You may have to reschedule your test for another day.

My bum is sore from all the bowel movements? What can I do?
There are a lot of bowel movements during a colonoscopy preparation. You can minimize soreness in the anal area by using a soft toilet tissue and/or a baby wipe such as Huggies. The application of a topical barrier cream such as Zinc Oxide, Butt Paste, or Desitin Diaper Rash Cream will not interfere with the results of a colonoscopy.

Can I drink wine or beer during the bowel prep?
No. The bowel prep may cause dehydration, and it's important to drink lots of water or clear liquids during your bowel prep to stay hydrated.

What about the medications I regularly take?
Tell your doctor about all medical conditions and any drugs, vitamins or nutritional supplements that you take regularly. If you are taking prescription blood thinners (Coumadin, Jantofen, Warfarin, Eliquis, Pradaxa, Plavix), please talk to your prescribing doctor. They may need to be temporarily stopped. Continue to take all medications unless otherwise instructed. If your take medications for high blood pressure, be sure to take them every day including the day of your colonoscopy prep and the morning of your procedure with only a small sip of water.

Constipation and bowel preparation.
One consistent factor that causes a poor preparation for colonoscopy is constipation. Starting the colon prep when you are constipated will make you sick, and probably result in an unsatisfactory preparation for the exam - which may have to be rescheduled. If you are constipated, you may require a "pre-prep" with a longer period of a clear liquid diet and additional laxatives to prepare your colon for your colonoscopy. Please make sure your Gastroenterologist knows that you are constipated before the procedure.

Should I continue to take my diabetic medications the day before my procedure?
Since you are on a liquid diet, you may need to adjust your diabetes medication the day before your procedure. Please refer to your diabetes instructions for details. In addition, check your blood sugar levels regularly during preparation as you it may not be safe to receive anesthesia for your procedure if your blood sugar is too high or too low.

I am diabetic and my blood sugar will go too low if I do not eat any solid foods, what should I do?
Drink liquids with added sugar the day before your procedure and do not rely on sugar-free drinks. You must consume 150-200 calories of carbs when you are on a liquid diet to maintain your blood sugar. Do not eat any solid foods during your preparation or your procedure may have to to be re-scheduled.

Can I have a colonoscopy if I am having a period?
Yes, menstrual periods, and tampons do not interfere with a colonoscopy.

Before your colonoscopy

How soon can I have a procedure performed?
Most routine procedures are scheduled within 4 weeks of seeing the doctor. We also reserve some appointments on our schedule for urgent cases.

Why do I have to fill out paperwork and answer questions at the endoscopy center when I already answered them at the doctor's office?
Medicare-accredited facilities are required to have a separate chart for all patients. In addition, our staff is trained to make sure we have your most up-to-date health information. Although the Three Rivers Endoscopy Center is located next to the CDH&N offices, it is a separate business entity.

Why do I need to leave my jewelry at home?
Small items of jewelry can easily be lost when changing into a patient gown before the examination.

What other guidelines should I follow before my procedure?
Ideally, you should wear loose, comfortable, casual clothing that is easily removed and folded. Avoid girdles, pantyhose, or tight-fitting garments. We recommend leaving your jewelry, other valuables, and high heels ((really?)) at home. Do not wear dark nail polish, perfume or cologne on the day of surgery. (Many people question the nail polish. Dark nail polish interferes with the readings of the pulse oximeter we put on your finger to alert the clinical team of your oxygen level.)

What do I need to bring with me on the day of the procedure?
Bring your insurance card(s), a driver's license or valid photo ID for identification purposes, plus any financial patient responsibility details, such as a copayment. If you are vaccinated for Covid-19, bring proof of vaccination cards for both you and your driver.

Can I brush my teeth and apply deodorant on the morning of the procedure?
You may brush your teeth, but avoid swallowing any additional, unnecessary water. Refrain from using mouthwash. You may apply deodorant on the morning of your procedure.

Questions about sedation

Is a colonoscopy painful?
No. During the examination, you will receive intravenous pain suppressants and sedation. You will not be aware of the procedure and should not experience any pain.

Is the sedation safe?
Yes. Before the procedure, you will be evaluated by the Anesthesiologist. During the procedure, you will be continuously monitored by a Certified Registered Nurse Anesthetists (CRNA) using the latest equipment.

What medications do you use?
Our CRNA's may use one of several medicines specifically selected for you based upon your health history. Medications commonly used are: Propofol (a sedative), Fentanyl (a narcotic used to control pain), and Versed (a medicine used to promote relaxation). This is called Monitored Anesthesia Care, or MAC. MAC anesthesia is perfectly suited to a short procedure like gastroscopy or colonoscopy. It is quick-acting, very safe, and you feel no pain or embarrassment during the procedure. The anesthesia wears off quickly in the recovery room, and unlike many other anesthetic regimens, post-operative nausea and vomiting is quite rare.

I'm afraid that I will say things that I shouldn't while sedated.
This is a normal and common fear. Most individuals are afraid of losing control, giving away their secrets, or saying something embarrassing while they are asleep. While in a state of MAC anesthesia, it is very unusual for patients to speak.

Will this be the same type of anesthesia as when I had my gallbladder removed? Will I have a breathing tube?
Anesthesia required for gallbladder surgery is a general anesthetic. An anesthetic for a colonoscopy or upper endoscopy does not require general anesthesia or a breathing tube. You will be breathing on your own and at the same time be pain free during the procedure.

Is it common to wake up in the middle of the procedure or to watch the procedure on the monitor?
No. The sedation administered by the anesthesia team takes effect almost immediately. Patients are completely sedated before the procedure starts, and usually waking up in the recovery area about three minutes after the procedure ends, with a sense of it all happening in "the blink of an eye."

Is it permissible to chew tobacco or “rub snuff” the morning of the procedure?
Our recommendation is that no chewing tobacco be ingested for at least 8 hours prior to your procedure. The liquid produced by your saliva, and mixed with chewing tobacco often ends up in your stomach. It is important that your stomach is empty of these kinds of acidic fluids prior to being administered anesthesia.

Can I chew gum the morning of the procedure?
Similar to chewing tobacco, gum also generates saliva that is then ingested, producing acid in your stomach. Therefore, we strongly recommend that you abstain from all gum, mints, etc. for at least 8 hours prior to the procedure.

I have had nausea after other procedures that required anesthesia. Will I experience this after my colonoscopy? Is it preventable?
Patients experience nausea and/or vomiting after procedures for a variety of reasons. Some are prone to nausea and vomiting due to other pre-existing conditions. Some patients have a history of motion sickness, which can be correlated with post-operative nausea and vomiting. Please let the attending anesthesiologist know your history if you suffer from this problem; in many cases, we can add medication or adjust medication to block that response. Because of the specific medications that we use for sedation, post-operative nausea and vomiting is rare after endoscopic procedures.

How will the anesthesiologist know how much anesthetic to give me for my specific procedure?
There is no single anesthesia or dose for all patients. Every anesthetic must be tailored to the individual and to the procedure that is being performed. The amount of anesthesia necessary varies according to age, weight, gender, prescribed medicines, or specific medical conditions. Heart rate and rhythm, blood pressure, breathing rate, and oxygen levels are monitored continuously during the procedure. Adjustments are made to anesthetic levels for each individual patient in order to keep the patient comfortable and safe.

Questions about procedures

What can I expect during the colon exam?
Sedation will be administered before and during your procedure to help you relax and make you sleep. You'll be on your left side as a flexible tube is slowly advanced into the rectum and colon. The procedure will cause you no discomfort.

How long will my endoscopic procedure take?
If you are scheduled for an endoscopic procedure, plan to be in our center for two to three hours. Procedures such as gastroscopy or colonoscopy require sedation for safety and comfort. Although the test takes about 30 minutes, you will need extra time for registration, preoperative check-in, the test itself, and postoperative recovery. Currently, our patients' average stay is less than three hours. Suggest to your accompanying adult to bring something to help pass the time. Free Wifi is available in our waiting room.

If the doctor finds a polyp during my procedure, will he remove it?
In most cases, yes. Our doctors are trained in the latest endoscopic techniques. All but the largest polyps can be removed at the time of colonoscopy. The polyp is then sent to a pathology lab for microscopic analysis. The final biopsy result is usually available within 10 days, whereupon the information from the report and any plans for followup care will be sent to you and your referring physician.

If the doctor takes a biopsy, does that mean I have cancer?
No. There are many reasons why your doctor may take a small sample or biopsy of your stomach or colon lining. Most have nothing to do with cancer.

Can my husband, wife, other family member, or friend come in with me during the procedure?
No. The physician will talk with your family or friend immediately following the procedure.

After your Procedure

Will the colonoscopy center keep me overnight?
No, you will not be kept overnight in the endoscopy center.

How will I feel after my procedure?
After your procedure, you will probably have a slightly dry mouth and feel drowsy, gassy, crampy and hungry. The dry mouth and drowsiness are caused by the sedation, and the symptoms will gradually wear off. The gassiness is a result of puffs of air that are introduced into the digestive tract during the endoscopic procedure to help your doctor examine the inside your stomach or colon. Most of the air is removed before the procedure ends, but some of it just has to pass naturally. Don't be surprised when you feel a small tube inside your rectum in the recovery room. This is inserted to facilitate the passage of air to reduce abdominal discomfort. The tube will be removed before you get dressed.

How soon will I be able to eat after my test?
As soon as you wake up, our nurse will offer you some juice. After you get home, you can have a light breakfast or lunch of whatever you feel like. Just go slow at first and use some common sense. ((why?))

Why can't I go to a restaurant after my procedure?
Because of having been sedated, you must NOT go out to eat, go home to eat. You may stop at a take-out on the way as long as you remain in the car.

Can I drink wine or beer after the procedure?
No. Since you will have received narcotics and sedatives during your procedure, mixing alcohol and these medications is dangerous. You may drink alcohol the following day.

Can I drive later in the day after my procedure?
No. You cannot drive your car or operate any machinery until the next day, also because of the sedation.

Why do I need to bring a driver for my endoscopic appointment? Does he or she have to stay the whole time I am there?
Endoscopic examinations such as colonoscopy and gastroscopy require sedation. The sedation is to relax the patient, but will cause grogginess for several hours, and slow reflexes for up to 12 hours. This is why you cannot drive your car or perform activities that require quick reflexes until the following morning. It is necessary for you to come with a friend or family member who can safely drive you home after your test is over. We recommend that your driver stays for the entire time you are being treated at our center. It helps us for them to be available to answer questions, and allows the doctor to explain your test results in the recovery room. If you arrive without an escort, your procedure will be rescheduled.

How soon can I return to work after my test?
Most patients are able to return to work the following morning.

Test Results

How long do I have to wait for the results of my procedure?
They are available immediately. Your doctor will, with your prior approval, discuss the results of the procedure with you and your family member or friend. We also give you a written explanation of the results, and what future treatment, if any, is anticipated. You or your family member will also have an opportunity to ask questions on your behalf as your memory may be impaired by the sedation. Any biopsies of samples taken for lab analysis will not be available on the same day as your procedure, but you will be contacted as soon as the results are received by our office.

If I have biopsies taken during my colonoscopy, what happens to my pathology specimen?
Three Rivers Endoscopy Center has its own pathology laboratory, with a highly skilled laboratory staff and a board-certified pathologist that provides high caliber results. Having an onsite laboratory simplifies direct communication between our endoscopists and the pathologist, resulting in better coordination of care for our patients, and quick test results to the physician. Our pathology laboratory is CLIA certified and contracted with most major insurances. Pathology services are billed separately.

How soon will I receive the results of any biopsies?
If any polyps are removed and sent to our pathology laboratory for examination, you will usually receive your results within one week of undergoing your procedure. Some health insurance companies have contracts with other pathology laboratories around the country, so your biopsy specimens must be mailed to that laboratory for examination, delaying your biopsy results for up to two weeks.

Insurance Issues

**How much does an EGD or colonoscopy cost at the Endoscopy center versus having it done at the hospital?
Our Endoscopy Center accepts most major insurance coverage plans. If you have a screening colonoscopy and no polyps are removed, the fee will be approximately $1500. If you have the same procedure at a hospital facility, that cost will almost double: $2500 - $3000. Your health insurance may pay all or part of this fee. Your health insurance may cover all or part of the expense. Any fees are established on the individual having the procedure. Fees may be discussed with our billing department staff prior to scheduling a procedure. You will learn exactly how the fees are broken down, what portion you will pay, and what your health insurance will cover, and if there are any additional fees that may apply prior to your appointment.

What insurance carriers do you accept?
Our website lists current health plans that are accepted at Three Rivers Endoscopy Center. The list is frequently updated, but may not include all plans accepted by TREC. Please contact our office if your plan is not listed.

Will my insurance plan cover my procedure?
Many insurance plans cover colonoscopy and upper endoscopy procedures. Insurance plans vary, so it is important for you to contact your insurance company to discuss your benefits. You will be responsible for any co-pay or deductibles. If you need assistance in determining your benefits, please contact our office.

If you are over 45 and have no colorectal symptoms and you're just having a routine screening colonoscopy, you may be eligible for a free colonoscopy every ten years. Call your insurance company for coverage verification. The procedure code is 45378 or G0121, and the diagnosis code is V76.51. If you're having a colonoscopy because a family member has had colon cancer, the diagnosis code is V16.0 and the procedure code is 45378 or G0105.

I have Medicare. How do I prove that my procedure is a medical necessity?
Your physician will order tests that he/she feels are medically necessary depending upon your symptoms or previous diagnosis. Should any of these tests be considered not medically necessary by Medicare, you will be asked to review our Advanced Beneficiary Notice which explains the services ordered, the cost of the services, and the reason why Medicare may not consider these services medically necessary. Should you choose to proceed with the treatment, you will sign the Notice accepting full financial liability.

Can you help me negotiate with my insurance company?
Should a claim for services be denied, we will assist you in working with your health plan.

What is co-insurance?
Co-insurance is the percentage of the cost for which you are financially responsible, according to your health plan. For example, if your insurance covers 70 percent of the allowable fee for a special service, you are responsible for paying the remaining 30 percent. This is called co-insurance. Co-insurance is not to be confused with co-payment.

What can I expect to pay out of pocket?
There are many variables to this question dependent upon our treatment suggestions. We can provide you with a co-insurance estimate prior to any services being scheduled.


What is CDHN's financial policy?
As a courtesy, CDHN will file health insurance claims to your health plan. You will be financially responsible for paying any deductibles, co-payments, and co-insurance costs.

I'd like to work out a payment plan with CDHN. What should I know?
It is the patient's responsibility to remit payment at the time of service. We understand that circumstances beyond your control can arise that create hardship. Please discuss any adverse financial situations by speaking with a billing manager BEFORE your visit to the clinic, or procedure if you will be unable to pay your balance in full on the day of your appointment.

How long do I have to pay my bill?
Once you insurance carrier has reimbursed us for your visit or procedure, any remaining balances will be billed to you. Payment is due upon receipt.

Does CDHN or TREC have an online billing option?
No. Not at the present time.

Why will I receive separate bills for my procedure?
You will receive one bill from our facility (Three Rivers Endoscopy Center), for professional services performed by the physician, one bill from the Anesthesia group that administered and monitored your sedation and one bill from the pathology lab if you had tissue biopsied or removed.

Who do I contact if I have questions about my bills?
When you have a procedure at Three Rivers Endoscopy Center, your insurance company will be billed by the following entities:

  1. The Center for Digestive Health will bill your insurer for the professional services provided by your gastroenterologist. Billing questions: (412) 262-1000.
  2. Three Rivers Endoscopy Center (TREC) will bill your insurance for facility cost, which includes the equipment, procedure rooms, supplies, staff cost, and medications. Billing questions: (412) 262-1000.
  3. Anesthesia, Our anesthesia provider will bill your insurance for the services provided by the Anesthesiologist and CRNA. Anesthesia billing questions: (412) 262-1000.
  4. Pathology Lab. If you had polyps removed, or biopsies taken the lab will bill your insurance for the laboratory's processing and pathologist's interpretation of the results of the biopsy specimens.

Our Location

Find us on the map

Hours of Operation

Our Regular Schedule

Primary Location


7:30 am-4:00 pm


7:30 am-4:00 pm


7:30 am-4:00 pm


7:30 am-4:00 pm


7:30 am-4:00 pm