We are committed to providing outstanding patient care, and therefore want to make sure you completely understand our payment policies.
Insurance: Our practice accepts and will bill all insurance plans. However, if we are not registered as a participating provider with your insurance, any amount not covered by your plan will become your responsibility. You can verify participation by contacting the number on the back of your insurance card. We do not bill Worker’s Compensation or MVA.
Proof of Insurance: All patients must present a copy of their current insurance card to provide proof of insurance. If you fail to provide correct insurance information at the time of service you will be responsible for all charges until coverage can be verified.
Self Pay Accounts: Self pay accounts are patients without insurance coverage or patients without an insurance card on file with our practice. It is always the patient’s responsibility to know if the practice participates with their insurance plan. If there is a discrepancy with the insurance information on file with the practice, the patient is considered self-pay unless otherwise proven. Self-pay patients are expected to make a down payment at the time of making the appointment ($100 for new patients and $50 for established patients). If the down payment does not cover all treatment charges, a statement will be sent to the patient at a later date reflecting their account balance. In order to make our services accessible to patients lacking health care coverage, Lakeside ENT offers a 20% discount to self-pay patients. Payment plans are available if needed. It is not the intention of the practice to cause hardship to patients, only to provide them with the best care possible and the least amount of stress.
Co-payments, Deductibles, and Outstanding Balances: All co-payments must be paid at the time of service. Those who are unable to pay their co-pay or back balances may be asked to reschedule. Knowing your co-pay amount is your responsibility and can be verified by contacting the number on the back of your insurance card. You will receive a bill for any applicable deductibles following receipt of your insurance company’s benefits determination. We accept cash, checks, most major credit cards, debit cards, and FSA’s. For your convenience, payments may be made by phone with our billing department. If for any reason a check is returned by the bank; the patient account will have the payment retracted as well as an applied check fee of $20.
Non-Covered Services: Please be aware that some and perhaps all of the services you receive may not be covered, or considered reasonable or necessary, by Medicare and other insurers. Payment for these services will be due at the time of your appointment.
Hospital Services and Post Operative Care: Many hospital services require co-payments to both the attending doctor and the facility. The assignment of these charges is based on the explanation of benefits provided by your insurance. As we have no staff at the hospital, we will send you a bill at no extra charge. If you have questions, please contact the number on your bill.
The insurance company may determine that certain procedures performed during the post operative period are not included in the initial surgical care. Should a co-payment or other patient out-of-pocket expense be assessed by the insurance company, we will send you a bill at no extra charge.
Claim Submission: We will submit your claims and assist you in any way we reasonably can to help you get them paid. Your insurance company may require you to supply certain information directly. It is your responsibility to comply with their requests. Please be aware the balance of your claim is your responsibility regardless of whether or not your insurance company pays your claim. Your insurance benefits are a contract between you and your insurance company. We are not party to that contract. For contract specific questions (i.e. deductible concerns) please contact your insurance company directly.
Coverage Changes: If your insurance changes, please notify us so we can make the appropriate changes to ensure that you receive your maximum benefits. If your insurance company does not pay your claim within 45 days, the balance will automatically be billed to you.
Non-Payment: Our office reserves the right to submit claims not paid within 90 days of the initial billing statement to an external collection agency. Should this action be taken, we will be unable to schedule non-emergent appointments, as well as applying a collection fee of 22%. If a patient has an account in external collections payment in full must be made prior to their next appointment. Patients’ who have been submitted to external collections two or more times may be discharged from the practice. Patients with overdue balances, which have not been placed in external collections, are required to pay their previous balance and any applicable co-pays at their appointment. A late fee of $15 may be applied to a balance, if the balance remains unpaid each 30 days. If a patient cannot pay the full amount a payment plan must be arranged with the billing department. If a patient presents to an appointment without their applicable co-pays a billing fee of $15 will be applied to the account.
- Lakeside ENT will refund over payments accurately and timely.
- Refunds under $10 will not be issued to patients unless a written or verbal request is received from the patient/guarantor.
- Any overpayment received as a result of billing error will be promptly repaid to the appropriate payer after discussion with the director of patient financial services.
- To request a refund contact our billing department
Our practice is dedicated to providing outstanding treatment to our patients. Our fees are representative of the usual and customary charges for our area. Let us know if you have any questions or concerns.