- You will be asked to complete a registration form each year and update and/or confirm the accuracy of this information at every visit.
- For your protection, we require personal identification. Bring your driver’s license or picture ID with you on every visit.
- Our registration form is available on our website.
Cancellation and No Show Policy
- We require 24 hour notice if you wish to cancel and reschedule your appointment.
Insurance Cards and Insurance Filing
- As a courtesy to all our patients, we will file insurance claims to your primary and secondary insurance carrier.
- You must bring your current insurance card to every visit to file insurance claims on your behalf. It is your responsibility to inform us in a timely manner of any changes to your billing information.
- If an insurance company denies payment for incomplete or incorrect information provided by you or for noncovered services, you will be expected to pay for services in full.
- If we do not participate in your insurance plan, be aware your benefits may be reduced.
- We do not file school or automobile insurance.
- We do not participate in any hospital affiliated Charity Programs.
- If your insurance requires an authorization for office visits or procedures, it is your responsibility to make sure we have authorization prior to the visit or service.
- If you want to be seen without an authorization, you will be considered a self pay patient and required to pay in full for all services.
- Our audiologists use the latest diagnostic technologies to identify, diagnose and treat your hearing and balance disorders.
- During your visit, you may undergo vestibular testing to determine the cause of your dizziness.
- Hearing aids may be recommended based on the results of your evaluations.
- We accept Cash, Check, Money Order, Visa, MasterCard, Discover and American Express.
- Patients are expected to pay for all estimated co-pays, deductibles and coinsurance at the time of service as required by your insurance company.
- Patients may also receive a monthly statement for any unpaid services by patient or insurance.
- Returned check fee of $25.00.
- Medical record fee of $25.00 in advance for completion of disability forms.
- It is impossible to determine what the cost of the care will be prior to the date of service.
- We require a minimum payment of $200.00 up front prior to seeing the doctor for new self pay patients.
- Additional payment may be required at time of checkout for services rendered.
- Patients who do not have insurance will receive a 20% discount on charges if paid in full on date of service.
- Patients will be billed for any balance not paid at checkout due upon receipt of statement.
Liability and Workers Compensation
- We require written authorization by your employer or workers compensation carrier PRIOR to your visit. If you claim is denied, you are responsible for payment in full.
- We do not accept assignment in the case of liability/legal actions.
- Payment of the bill is the responsibility of the person receiving treatment.
- Patients under the age of 18 must be accompanied by the parent or guardian.
- The parent who consents for treatment will be the responsible party on the account and is responsible for all charges regardless of divorce or separation decree.
- We request patients age 18 or older covered under their parents insurance to sign an authorization allowing Charleston ENT to contact parents regarding insurance and billing issues.
Extended Payment Plans and Financial Assistance
- Please call our billing office to discuss any extended payment plan options.
Termination/Discharge from Practice
- The following scenarios may jeopardize the patient/physician relationship in which Charleston ENT will terminate and discharge the patient from the practice. The patient will be sent a letter of discharge.
- Noncompliance/Abusive Patients.
- Excessive no shows.
- Failure to meet financial obligations.