Insurance & Payment Information

In an effort to better inform our patients of their financial obligations, we have implemented the following Financial and Insurance Policies. Please read all of the information below. Your cooperation in following our Financial Policy will allow us to better serve you.

Insurance

If you have a health insurance plan that Northeast Georgia ENT participates with, then you are not obligated to pay any balance in excess of what your insurance company is contractually obligated to pay. However, you (the member) are responsible for co-payments, deductibles and any non-covered services.

We will attempt to notify you of any special services you may require that are not covered by your insurance company but ultimately it is the responsibility of the member to know their insurance benefits. Please be aware that specific plans may require a written referral prior to consultation. It is the responsibility of the member to make sure appropriate referrals have been received. Please contact your health plan prior to your visit if you have questions about our participation with your insurance plan or your insurance benefits.

If you have a health insurance plan that Northeast Georgia ENT does not have a contractual agreement with, you will be responsible for any and all fees that exceed or are not covered by your health insurance benefits.

It is of the utmost importance that you provide us with current copies of your insurance card and notify us immediately if there are changes in this information.

No Insurance

For services rendered to uninsured patients at Northeast Georgia ENT, a minimum payment of $200-300 is required prior to seeing the physician and the remaining balance is due at check out unless other payment arrangements are made in advance. For elective surgical services, payment in full is required a minimum of two weeks prior to the surgery date unless other arrangements are made in advance.

Good Faith Estimate

Under the law, health care providers are required to provide patients who do not have insurance or who are not using insurance with an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item.
• You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Medicare Patients

We submit and accept assignment on all Medicare claims. As a courtesy, we will file your secondary insurance.

Referrals

Some insurance plans require a written referral prior to an office visit. Referrals are usually obtained by the primary care physician. However, it is the responsibility of the member to confirm that a referral has been obtained. If you do not have a current referral, you may be asked to reschedule your appointment or sign a waiver stating that you will be responsible for payment of services rendered.

Co-payments

Co-payments are to be made at the time of service prior to seeing the physician. We accept Visa, MasterCard, American Express, Discover, check or cash.

Monthly Statements

Any outstanding balance is due immediately upon receipt of statement. Payment by Visa, MasterCard, American Express, Discover or check is appreciated.