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Upper Gastrointestinal (GI) Series Date: _____________ Time: _____________ Check-in: _____________ 700 Ironwood Drive, Suite 175 Coeur d’Alene, Idaho 83814 208.625.6300 tel What is an Upper GI Series? An upper GI series is an X-ray examination of your upper gastrointestinal tract, including the esophagus, stomach and part of the small intestine. Why is it Performed? This procedure may be performed if a patient is experiencing frequent heartburn or stomach pain, or if your doctor suspects an ulcer or blockage. Other reasons may include diarrhea, unusual weight loss, difficulty swallowing, regurgitation (reflux), rectal bleeding, blood in stools, or vomiting blood. How is it Performed? The examination takes about an hour, including prep time. You will either be asked to stand at the end of an erect X-ray table or to lie down on a tilting table attached to a fluoroscope, which is an X-ray unit, combined with a television screen. You may be asked to swallow baking-soda granules to help put air (gas) into your stomach. The radiologist will give you a liquid barium milkshake to drink which allows the radiologist to see your organs in greater detail. How to Prepare For the examination to be successful, your stomach and upper GI tract must be completely empty. You will be asked not to eat or drink anything after midnight the night before the exam. You should also not chew gum or smoke as these activities can increase stomach secretions which may affect test results. Be sure to inform your physician of any medications you are taking, allergies, all recent illnesses or other medical conditions, or if you may be pregnant. Insurance & Billing Information Kootenai Outpatient Imaging patients will receive two statements, one for technical services from Kootenai Health and the other for radiologist interpretation from Kootenai Imaging. Billing Questions? Kootenai Health customer service: 208.625.6199 or 888.974.1235 toll free • kh.org and click on Pay My Bill Online Kootenai Imaging customer service: 877.318.7270 • peryourhealth.com Insurance plans may require a referral, deductible, co-payment or preauthorization. It is the patient’s responsibility to be aware of these requirements. Your insurance contract is between you, your employer and your insurance carrier. Please contact your insurance carrier with questions on your specific coverage. All domestic insurance carriers will be billed. Patients with contracted insurance carriers may benefit from a contractual rate adjustment. Submitting Your Payment Payments for Kootenai Health can be made: • In person: 1221 W. Ironwood Drive, Coeur d’Alene, ID 83814, M-F, 7:30 a.m. – 4:30 p.m. • By mail: Kootenai Outpatient Imaging, 2003 Kootenai Health Way, Coeur d’Alene, ID 83814 • By phone: 208.625.6199 or 888.974.1235 toll free M-F, 7:30 a.m. – 4:30 p.m. • Online: Visit www.kh.org and click on Pay My Bill Online Coeur d’Alene, ID AmeriTel Inn Shopko Shari’s Wells Fargo Albertsons U.S. 95 (Lincoln Way) Kootenai Health Way Exit 12 McGrane Center Health Resource Center Imaging Services Parking Garage Ironwood Dr. 90 Lakew ood D r. Exit 11 Northw est Blv d. Ironwood Dr. 1919 Lincoln Way Kootenai Outpatient Imaging