We are contracted with many HMOs, PPOs and other health insurance plans including Medicare.  Each plan contains unique rules which must be followed by patients. Please familiarize yourself with the particular benefits and rules of your health care plan since the contract is between you (the patient) and your health insurance carrier.

Regardless of your medical insurance coverage, our office relies on you for settling your account. You are ultimately responsible for all fees related to your care. Your health insurance policy is an agreement between you and your health insurance carrier. If you need to make special arrangements for payment, please contact our billing office.

                           Co-Pays and Deductibles
It is your responsibility to pay co-pays, co-insurance, deductibles or any balance not paid by your insurance company.  Some companies pay fixed allowances for certain procedures while others pay a percentage of the charge.  Please be aware of your annual deductible and whether or not you have met it.

We are required by our contracts with your insurer to collect co-payments for services at the time rendered.

Many changes have taken place in the health insurance industry in recent years. Procedures and services once covered in full are now partially covered, covered only under certain circumstances or in some cases not covered at all. 

                                               Billing
As a courtesy, we will initiate a claim to your insurance company on your behalf.  Once our claim has been sent to the insurance company, they send you a copy of your explanation of benefits (EOB) in addition to the one they send our office. It clearly notes what they paid the doctor; co-pays, co-insurance, deductibles, discounts and adjustments.  After we receive our EOB, we will then bill you for any remaining “patient responsibility”. You are responsible for any deductibles, co-insurance, and non-covered services.

                                 Supplemental Insurance
If you have supplemental insurance through which we are contracted, we will gladly initiate a secondary claim on your behalf.  However, the balance from your primary insurance will become your responsibility if payment from your supplemental insurance is not received within 45 days from which the claim was filed.

                                               Insurance Deadlines
Many insurance companies have Timely Filing Deadlines. It is your responsibility to inform us of any insurance changes.  If we are not provided with accurate information at the time of service, you may be responsible for the payment in full for all services rendered.

                             Referral authorizations
Certain health insurance plans require that you obtain a referral/authorization from your Primary Care Physician (“PCP”) before visiting a specialist’s office like ours. You are responsible for obtaining this referral authorization and keeping track of the number of visits allowed as well as the start/end dates of your referral/authorization.

                                     Out of Network Plans
We try to verify all patients’ insurance benefits before you arrive at the office.  There are insurance plans that we are not in network with.  If you are out of network and still want to be seen by our office, please be advised that you will be responsible for the full amount at the time of visit.  As a courtesy we will provide you with a receipt and billing information so that you may file for any reimbursement from your insurance company.

If your supplemental insurance is out of network you will be responsible for your primary insurance co-pay, co-insurance or deductible.

                                               Methods of Payment
We accept VISA, MasterCard, Discover, personal checks, and of course cash. There is a fee of $25 for any checks returned by your bank. We also accept Care Credit. A Care Credit application can be obtained from our billing office or online at www.creditcare.com.

                                             Self-Pay
For the initial self-pay consultation, we collect the consultation fee in full prior to your seeing the doctor. This fee covers the initial office visit only. Payment for any additional procedures will be required at the time of service. For subsequent follow-up appointments we are happy to apply a 25% self-pay discount, but payment is due in full at the time of the visit.  If you are self-pay, please let us know ahead of time so that we may give you a complete breakdown of anticipated charges before services are rendered.  Payment arrangements are available for procedures upon request and approval.

                   Auto Accidents and Workman’s Comp Claims
We do NOT handle auto-accident insurance or workman’s compensation claims.  If you need to see one of our doctors as a result of an auto accident or workman’s compensation claim we require payment up front as per our self-pay policy. We will then give you a receipt which you can submit for reimbursement

                                       Past-due accounts
Due to increased postage, printing costs, and staff time... we will only send you three statements prior to referring your account to a collection agency. Our office sends out statements every two weeks. If a second statement is required a $10 late fee will be added to your account balance. If a 3^rd statement is required a 30% surcharge will automatically be added to your account. If your account is not paid in full within 10 days from the 3^rd statement your account will be reviewed for collection action. Once your account is at collections the account is legally out of our hands. We would much rather work with you, so please be prompt in paying your bill or contacting us if you need to make acceptable payment arrangements.

                                   Financial Responsibility
We wish to stress that financial responsibility for services rendered rests with the patient or his/her family regardless of the nature of extent of any insurance coverage.  Because your insurance carrier does not pay your bill on time does not relieve you of your responsibility for payment of the bill within 60 days. This means its important to keep us advised of any changes regarding your insurance or personal information. If you pay a bill and then the insurance company pays your claim, we will refund you any amount due within 30 days.

The information we request for on our patient information forms  is vital to your care and making sure that insurance matters are taken care of. Please be assured that your personal information is kept strictly confidential.

Please advise the receptionist when you come in of any changes in your address, phone number, marital status, place of work, or insurance coverage since your last visit. Please feel free to report to us any complaints you have about our charges, services, or any inattention from any office personnel. We will do our best to correct any errors we have made.  Please help us to help you.

It is important to understand that professional care is provided for you and not to an insurance company. Thus the insurance company is responsible to the patient and the patient is responsible to our office for any balance not paid by the insurance.

                               What if I can’t pay my account?
Payment is expected at time of service.  We will be sensitive to your financial circumstances within the framework of sound business practices.  We want to be concerned with your medical needs, not financial responsibilities.

                                       Collection Agency
Any outstanding balances are due within 30 days of the statement.  All balances reaching 90 days past due may be sent to a collection agency. Should your account be sent to a collection agency, you will be financially responsible for all collection fees and legal fees our office incurs through the process utilized to collect the delinquent balances. Please remember, legally your account can be turned to a collection agency the day it is due. We want to avoid this and are willing to make arrangements with you.

               Divorced/Separated Parents of Minor Patients
The parent who consents to the treatment of a minor child is responsible for the payment of services rendered.  South Tulsa Ear Nose and Throat Center will not be involved with any separation or divorce disputes.