excellent. quality. CARE.

BILLING & FINANCIAL POLICIES

 

Deductibles, Co-pays, Co-insurance, and Non-covered charges

• Our practice participates in many insurance plans and each one has different coverage and benefit details.  Most insurances will have a "co-pay". Your insurance may also have a "deductible", which means the amount you are responsible for before insurance starts covering the rest. You may also have "co-insurance", which means a percentage of the charges you will be responsible for.

• Your deductible may or may not apply to office visits. We will try to verify beforehand but may still not know until your claim is processed and we receive the Explanation of Benefits (EOB).  **If you have a deductible remaining on your insurance, it is our office policy to collect a deductible deposit of $150 for new visits and $85 for follow ups. This will be applied after we receive the EOB. Any amount left over from the deposit will be credited to your account or refunded back to you.  If the deductible applies to surgical procedures, an amount will be estimated based on expected charges and collected before surgery is performed.

• Co-pays and non-covered charges are due at the time services are rendered. Remaining deductibles and co-insurance will be due after explanation of benefits is received. It is your responsibility to understand your policy coverage.  Our billing staff is available to assist you with questions about coverage limitations and payments.

 

**The deductible deposit will not be required if you use our Credit Card on File Process. This will help make payments easier and avoid unnecessary charges.  We will always notify you before we process your card once the insurance claim is processed.  Please see below for information about the Card on File process.**

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Insurance termination or incorrect insurance information

• If your insurance coverage terminates or becomes inactive during the period you have received services, you will be liable and billed for any office visits or procedures at self-pay rates determined by the office.  If you give the incorrect insurance information or incorrect primary insurance coverage which results in a refund of reimbursements or non-payment from the insurance company, you will also be liable and billed for any services received at self-pay rates.

 

Card On File Process

• You have the option to keep a credit or debit card on file for deductibles, co-insurance, co-pays, or incidental charges.  You will be required to keep a card on file if you have a deductible remaining on your insurance and elect not to place a deductible deposit.  Our office has the ability to securely store your credit or debit card through a third party associate, TSYS.  This process benefits you by allowing easier, faster, and more efficient payments.  It simplifies payment for you and eases administrative burden on our practice.  It reduces paperwork and ultimately helps to lower the cost of healthcare.  It can help reduce your cost by avoiding late payment fees and delinquent accounts.  We will always notify you before charging your card of any outstanding or remaining balances after we receive the Explanation of Benefits from the insurance. A receipt will be sent afterwards.  Cards are securely stored by TSYS via PCI compliant token system which encrypts the numbers.  No card numbers are stored on the office computers!

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It is our goal to be transparent with you regarding any billing matters given the complexity of our healthcare and insurance system these days!  You can email: billing@entpromd.com with any questions or concerns.

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OFFICE POLICIES

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Late arrivals/Cancellations/No-Shows for Office Visits and Surgery and Other Fees

• We understand that there are times when you must miss an appointment due to emergencies or obligations for work or family. However, when you do not call to cancel an appointment or notify us, you may be preventing another patient from getting needed treatment.

  • Late arrivals:  If you arrive late for a scheduled appointment, you may be asked to wait until prior patients have been seen or you may reschedule your appointment.

  • Cancellations:  You must notify the office at least twenty-four (24) hours in advance to cancel office visits or seven (7) days in advance to cancel surgeries, or we may consider you a “No-Show”.

  • No-Shows:  We reserve the right to charge a fee for missed office visits and surgery appointments. This will not be covered by your insurance company.

  • Late payment fee: If more than 2 statements need to be sent, there will be a late payment fee added to the statement balance for each additional statement sent.

 

Please call our office if you have any questions or want more details regarding our policies.

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Thank you for helping us run a better practice!  We appreciate you for choosing ENT Professionals of Maryland!

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