Thank you for choosing Great Lakes Ear, Nose & Throat Specialists! We are committed to the success of your medical treatment and care. Please understand that a mutual financial understanding is part of our relationship.
Payment is Due at the Time of Service
- We accept cash, checks, debit, and Care Credit.
- All co-payments, deductibles, co-insurance and fees for non-covered services are due at the time of service.
- Insurance required co-payments are due when you check-in for your appointment. If you arrive without your co-payment, we may ask you to reschedule.
- If your co-payment is based on a percentage (example: 20% of the allowed payment) and you do not have a secondary policy, please be prepared to pay a minimum of $50.00 on the date of service.
- Patient-responsible balances are due when you check-in for your appointment.
- In the event you need surgery, we will provide you an estimate of your insurance required deductible and co-insurance amounts.
Proof of Insurance
- Your insurance card(s) and a valid photo ID are required at the time of appointment.
- It is your responsibility to notify the Practice of changes in your health insurance.
Self-Pay Accounts
- Self-pay patients, please be prepared to pay a minimum of $100.00 on the date of service. There may be additional fees for in-office procedures, labs, or services.
Referrals
If you have an HMO plan we are contracted with, you need a referral authorization from your primary care physician. If we have not received authorization prior to your arrival at the office, call your primary care physician to obtain it. Without an insurance required referral, the insurance company may deny payment for services. As such, if you are unable to obtain the referral at that time, you will be rescheduled or asked to pay for the visit in advance.
Divorce and Child Custody Cases
- In cases of divorce, the individual who receives care is responsible for payment of co-payments, co-insurance, deductibles, and nonparticipating insurance balances at the time of service. We will not bill a divorced spouse for the patient’s services.
- The parent who brings the child to the office for care is responsible for payment at the time of service, no matter if the account is self-pay, participating insurance, or nonparticipating insurance. The Practice does not honor divorce specifics (e.g., percentage of financial responsibility).
No-Show/Cancellation Policy
- Please be advised that cancellations made less than 24 hours before a scheduled appointment will be subject to a $25 cancellation fee.
- Not showing up for your scheduled appointment will also result in a $25 “no-show” fee. If you are scheduled for an audiology and ENT appointment on the same day, this is considered as two appointments, and therefore, the charge will be $50 for said “no-show”/same-day cancellation fees.
- The cancellation/”no-show” fee is required to be paid before another appointment can be made.
- If you “no-show” or cancel for three appointments, Great Lakes Ear Nose & Throat will have the option of discharging you as a patient from the practice.
Billing, Payments and Refunds
- If we must send you a statement, the balance is due in full within 14 days of the statement date.
- If you cannot pay the balance in full within 14 days, please contact our billing department to see if you qualify for special payment options.
- It is your responsibility to notify the office of any change in address, phone, employment, or insurance coverage.
- If you make an overpayment on your account, we will issue a refund only if there are no other outstanding debts on other accounts with the same guarantor or financially responsible party.