Financial Policy

Thank you for choosing Plymouth Ears, Nose, and Throat as your medical care provider. We are committed to delivering the highest quality of care while a(so ensuring we operate transparently regarding costs and bitting practices. This encompasses providing necessary information upfront and helping you make informed decisions. lt i5 important to outline that the relationship ties between medical provider and patient, not with the insurance company. Patient’s are entrusted with understanding their healthcare coverage, including what services are covered, their financial responsibilities, and adhering to the guidelines set by their insurance provider. For your convenience, this document discusses a few commonly asked financial policy questions. lf you need further information about any of these policies, please ask to speak with our Practice Manager. Do I need a referral or pre-authorization? lf your insurance plan requires a referral authorization from your primary care physician or a preauthorization from your insurance, you will need to contact your primary care physician or insurance company to be sure lt has been obtained. lf we have yet to receive authorization prior to your appointment time, we with schedule. Failure to obtain the referral or preauthorization may result in tower or no payment from the insurance company, and the balance will become patient's responsibility. When are payments due? Payments are due at check-in prior financial( arrangements have been made. Thee payments may consist of, but are not limited to; copayments, deductibles, and past-due balances. lf copay is due and not paid at time of visit, your appointment will be canceled, Retuned checks or payments will result in a minimum S35.00 penalty in addition to balance owed. What if my insurance is not accepted by you? We follow the "No Surprise Billing Act" and will have you sign an out of network form that outlines all details and payments, We will bill all commercial and non-contracted plans as courtesy, as they may have out of network benefits. Any partial or unpaid balances after 30 days of initial submission to the insurance plan becomes patient responsibility, and are due upon receipt of the firststatement. Wilt you bill my insurance? We bill your primary insurance company on your behalf. insurance is a contract between patient and the insurance company. ln most cases, these contracts are not disclosed to us. To property bitt claims, alt necessary information is required to be current. Any changes or updates to address, nameJ and insurance cards should be catted or brought in prior to next appointment, Failure to provide complete and accurate information may r6utt in the entirety of the bitt fatting to patient responsibility. What if l don't have insurance? Uninsured or "self-pay" patients will be required to make an initial deposit of $35O.OO at time of service. Pricing and payment options can be arranged with our billing department. lf there is a discrepancy with the insurance information on file, the patient will be considered self-pay until otherwise proven. At the sole discretion of the practice, extended payment arrangements may be made for patients. lt is never our intention to cause hardship to our patients, Our goal is to provide quality care at affordable costs.

Why did I receive more than one bill for mv surgery/ procedure/ testing services? Please note that while we only bill for services rendered by our team during appointments and procedures, testing services are often done by using outside laboratories or facilities. We do our best to only use participating facilities; however, this is not always possible. This may result in separate deductibles, copays and coinsurance claims. We are a specialty office, and some insurance plans consider our procedures performed as “surgery”, which can result in surgical copays and deductibles. Most patients coming into the office will have some form of nasal scope in order for us to properly diagnose, which can result in the charges up to $1,000. lf you do not wish to be scoped please inform the provider at the time of visit. Some of our commons procedures and test are: NasalEndoscope Nasopharyngogcopy PH,/Manomary Allergy Testing Ultrasounds Strobes Debridement Any and all nasal scopes FNA What is a deductible? Deductibles are the patient's responsibility. lt is a dollar amount or percentage determined by your insurance plan that must be met before the insurance policy begins paying for covered expenses. That information is available to you through the insurance company. We ask that each patient consults with their insurance company prior to appointment for deductible totals and remainders. What is I miss my appointment? We understand that issues arise and some appointments cannot be kept. Our highly skilled clinical team is committed to your well-being and has reserved time just for you. Patients unable to provider a 24 hour notice for a doctor may incur a fee. Appointment No Show Policy We require a 48 hour notice to cancel or reschedule any diagnostic testing taking place at Plymouth Ears, Nose and Throat. Otherwise, a 'No Show Fee' of $100.00 will be billed to the responsible party. This includes but is not limited to AVE, Allergy Testing, PH/Manometry, FNA, Strobe and Ultrasounds.

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Financial Policy

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30 Aldrin Road, Plymouth MA 508-746-8977

1 County Road, Bourne MA 508-746-8977

104 Park Street, Hyannis MA 508-746-8977

544 Main Street, Weymouth MA 508-746-8977