Financial Policy

Upload: September 29, 2015


  • You must provide proof of current insurance at every visit as well as update your demographics.
  • You must provide a referral if required by your insurance company prior to your visit or pay cash.
  • Medicaid and Medicaid Managed Care patients cannot be seen without a referral.
  • You are responsible for any co-pays, deductibles and coinsurance as required by your insurance company at the time of service. A $10 processing fee will be added if the co-pay is not provided.
  • We cannot get involved in family disputes. The parent that brings the child for the visit is responsible for payment.
  • Your insurance policy is a contract between you and your insurance company; therefore it is your responsibility to know your benefits.
  • All fees generated are the responsibility of the patient.
  • Insurance plan participation is subject to change.
  • If we are not contracted with your insurance company, we do not accept their fee schedule as payment in full. Any balance is the patient's responsibility.

Diagnostic Scopes

  • Diagnostic endoscopy is an important tool used to diagnose naso-sinus and other ENT conditions.
  • Your insurance company may consider diagnostic endoscopy a "surgical procedure" for billing purposes.
  • The charge may be subject to additional deductible or coinsurance according to your surgical plan benefits.
  • As with all healthcare services, you can decline this endoscopy, but your physician may feel it is optimal for proper diagnosis and treatment.


Missed appointments require 24 hours prior notice. If proper notice is not given, the fees are as follows;

  • Missed physician appointment $50
  • Missed VNG $100
  • Missed audiology test is $50
  • Missed in office procedure $50
  • Missed allergy testing appointment $100

Collection Agency

All patient accounts that become 60 days delinquent may be sent to an outside collection agency, or attorney. This will result in dismissal from the practice and all accounts turned over to collections will be assessed with a 35% administrative fee.