ENT, SINUS & ALLERGY – ADVANCED HEALTH (ADI)
OFFICE FINANCIAL POLICY
Our charge for services, including office visits and procedures, are based upon the severity and complexity of injury or illness as well as time spent treating you. Our staff will be glad to discuss our fees with you. Make sure that you give Current and ALL insurance information every time you visit the office, so we can file appropriately. If you do not, then the balance may become your responsibility. Please do not hesitate to inquire about the charges for our services.
Payments are payable at the time of the treatment or when service is rendered. Regardless of your medical insurance coverage, our office relies on you to settle your account. For your convenience, we offer the following payment options:
- Payment in full.
- Payment of the portion your insurance will not cover (co-payment, coins, out of pocket or deductible) on the day the service is provided.
If other arrangements are needed, please talk to our office staff prior to receiving services.
We accept Medicare assignment. Our office will submit all claims to Medicare. We will submit to your secondary insurance, provided you have given our office the necessary insurance information.
We accept most TennCare products, please verify prior to services. IF you have a primary insurance, please give this information as well. You will be held responsible for services rendered if appropriate information is NOT given. The State of TN Bureau of TennCare is informed of all insurance that you have from a central database through the State of TN and will deny your claims if appropriate filing has not been made. Therefore, the patient will and can be held liable.
Our office will submit primary and secondary insurance claims for you. However, we require current information prior to the service being provided. Policy coverage varies from one insurance plan to another, as do the “usual, customary and reasonable” fees that various insurance plans have established. Our fees are accepted by most plans, but occasionally one of our patients are notified that the amount for our service exceeds “UCR FEES”. The final responsibility for services provided is the patients/guardian.
Payment is due in full for all charges incurred on the date of service including but not limited to procedures. If a patient is in need of surgery, payment in full prior to surgery is required. Most surgeries are elective and non-emergent and can be scheduled when you are able to pay in full.
Payment is due in full on the day of service.
We review past due accounts frequently and at every statement cycle. Your communication and involvement to ensure your balance is paid timely is important to us. It is imperative that you maintain communications and fulfill your financial agreement and arrangements to keep your account active and in good standing.
If your account becomes sixty (60) days past due, further steps to collect this debt may be taken. If we must refer your account to a collection agency, you agree to pay all of the collection costs which are incurred. If we must refer collection of the balance to a lawyer, you agree to pay all lawyer fees which we incur plus all court costs. In case of suit, you agree the venue shall be Davidson County, Tennessee. In addition, we reserve the right to deny future non-emergency treatment for any and all debtor-related unpaid account balances.