Otolaryngology physicians are "specialists". Specialists are physicians who are experts in a particular branch of medicine. Based on your insurance policy, you may be responsible for a larger copayment for specialist office visits. This information may or may not be included on your insurance card. If you have any questions regarding your copays, please contact your insurance carrier.
Florida Otolaryngology Group, P.A. is contracted with many different insurance plans. If we are a contracted provider for your health insurance plan our office will file your medical claims. Also, as member of a health insurance plan, you are most likely entitled to a discount. The remaining charges are considered our "allowed amounts". You are financially responsible for any part of the allowed amounts not paid under your policy. Be aware that although our services may be "covered" by your insurance carrier, your insurance may require you to pay a co-pay, co-insurance or deductible before they pay the remaining charges. A common misconception is that health insurance plans are responsible for a patient’s medical bills. In truth, consumers are responsible for their medical debts. Your contract with your insurance carrier determines how much of your services they will cover; however you are ultimately responsible for your medical bills. Medical office visit charges can vary. Charges are based on the type of visit and the complexity of the exam. The physician will determine the appropriate level of service at the time of your exam. In addition, our physicians may perform diagnostic procedures or testing in order to care for your health. Depending on your insurance coverage, these may require an additional copayment, co-insurance or deductible. •We will do our best to let you know if we are in-network for your insurance carrier; however it is your responsibility to know your insurance plan. •If our office cannot file your claim due to inaccurate information (incorrect ID#s, incorrect dates of birth, old insurance information, etc.), you will be responsible for the full charges.
Many HMO plans require the patient to receive a referral from their primary care physician before receiving services from another provider. Depending on the insurance plan this could be a simple note or script recommending the patient visit an ENT (Ear, Nose and Throat physician), or a detailed referral which includes a specific physician, diagnosis, and authorization number. •Although our staff will try to assist in confirming that a referral has been issued, it is the patients’ responsibility to obtain authorization from their PCP.
Many insurance plans require a patient to pay a fixed amount toward every physician’s visit. In most cases this copayment will be the same regardless of the extent of the services provided; however there are a couple of notable exceptions. Otolaryngology physicians are "specialists". Specialists are physicians who are experts in a particular branch of medicine. Based on your insurance policy you may be responsible for a larger copay for specialist office visits. This information may or may not be included on your insurance card. Our physicians may perform diagnostic procedures in order to care for your health. These procedures are often invasive and are considered surgical by the American Medical Association and your insurance carrier. Depending on your insurance coverage, the procedures may require a higher copayment than listed on your insurance card. •Our office policy is to collect your copay at check-in. The amount collected is based on the information we have at that time. If your insurance company notifies us that a larger copayment was due, you will be billed for the difference.
Some health insurance plans require a patient to pay a percentage of their medical bills. As an example, a 20/80 plan would require a patient to pay 20% of the total allowed charges. The insurance plan would pay the remaining 80%. •Generally our office will bill the patient their exact co-insurance after an insurance company has processed the claim. We may require a payment toward your co-insurance for pre-planned services, such as surgery. In these incidents, our staff will determine your estimated responsibility as accurately as possible.
Some health insurance plans require the patient to pay a deductible. Your deductible is the amount you are responsible for paying yearly before the insurance company pays toward your bills. Insurance policies vary regarding deductibles. Some plans require a deductible for all services; others only require a deductible on surgical procedures. Our physicians may perform diagnostic procedures in order to care for your health. These procedures are often invasive and are considered surgical by the American Medical Association and your insurance carrier. Depending on your insurance coverage, you may owe a deductible for these services, even if you would not owe a deductible for an office visit. •Generally our office will bill the patient their deductible after an insurance company has processed the claim. We may require a payment toward your deductible for pre-planned services, such as surgery. In these incidents, our staff will determine your estimated responsibility as accurately as possible.
Our physicians may perform diagnostic procedures in order to care for your health. These procedures are often invasive and are considered surgical by the American Medical Association and your insurance carrier. Depending on your insurance coverage, these may require an additional copayment or deductible.
Most surgical procedures that are performed in an out-patient surgical facility have a post-op period. This period may extend from 10 to 90 days. Although there are no charges for your exam, there are charges for any procedures (such as a sinus debridement) or testing required during your post-operative care. A physician may want to follow-up beyond the normal post-op period. Normal office visit charges may apply. If you are treated by a physician for reasons not related to your surgery in this time frame, normal visit charges may apply.
Our physicians strive to provide quality medical care. In order to properly diagnose your throat problems, your physician may need to perform a flexible laryngoscopy or other diagnostic scope. This office procedure and other similar procedures use a scope to view inside your throat. These are considered diagnostic surgical procedures by both the American Medical Association and your insurance carrier. Based on your insurance coverage, you may owe an additional copay or deductible for surgical procedures. If you have any questions regarding your insurance benefits, please check with your insurance carrier.
Our physicians strive to provide quality medical care. In order to properly diagnose your sinus problems, your physician may need to perform a sinus endoscopy or other diagnostic scope. This office procedure and other similar procedures use a scope to view your sinuses. These are considered diagnostic surgical procedures by both the American Medical Association and your insurance carrier. Based on your insurance coverage, you may owe an additional copay or deductible for surgical procedures. If you have any questions regarding your insurance benefits, please check with your insurance carrier.
Our physicians strive to provide quality medical care. In order to properly diagnose your hearing problems, your physician may order an audiometric evaluation. These tests are for diagnostic purposes and are not considered “screening” tests. Audiologic testing is generally covered by your insurance carrier; however, your policy may contain limitations. If you are unsure of your coverage, please contact your insurance carrier.