Office Visits

Providing you and your family members with excellent care is of utmost importance to the physicians and staff at CornerStone Ear, Nose & Throat, PA. These frequently asked questions are designed to address the most common concerns expressed by our patients. While this is not an all-inclusive list, we recommend that you read over this information thoroughly and if you have additional questions or concerns, please don’t hesitate to contact our office.

Will I be required to pay a copay at my visit?

Your copays are part of your contract with your insurance carrier and it’s part of our contract to collect them at the time of service.

Why do I always have to complete the same information when I come in for a visit?

Insurance companies require a history and review of certain medical information at each date of service. In addition to insurance company requirements, it helps our physicians treat you and maintain a higher level of care by asking for a complete list of medications, surgeries, and medical problems at each visit.

I don’t need to know my insurance benefits, because the office does, right?

Patients are responsible for knowing the requirements of their insurance plans, including any copay, deductible or coinsurance amounts, which hospitals, surgery centers, labs and radiology facilities they may use, what services are covered, etc. Our staff will assist our patients, but we cannot be responsible for knowing or interpreting the benefits of each individual policy.

Will my insurance cover my visit and/or procedure?

Insurance coverage varies and exceptions can apply. If you have questions about what services are or are not covered under your plan, please check your benefits information. If you still have questions, please contact your insurance company.

Also, please be mindful of the difference between “coverage” and “payment.” A service can be covered and paid by your plan; or a service can be covered with the allowed amount being applied to your deductible, copay or coinsurance, making this amount the financial responsibility of the patient/guardian.

You accept the amount my insurance company pays as payment in full, right?

As indicated by the patient’s insurance policy, patients (or guardians) are responsible for paying plan deductibles, co-insurance, non-covered services and copays at or prior to the time of service.

I have insurance, so why do I have to pay for my charges up front?

As stated, patients or guardians are required to pay their estimated financial responsibility (deductible, copay and/or coinsurance). These required payments are part of your contract with your insurance carrier and it’s part of our contract to collect them.

Once I pay these amounts, I won’t owe any more, right?

Your estimated financial responsibility is based on benefits quoted by your insurance carrier. All estimated financial responsibilities are based on our contractual reimbursement from your insurance company and not on billed charges. After your insurance company processes your claims, your account may be paid in full, or have a balance or credit due. If so, you will receive a bill or a refund from CornerStone Ear, Nose & Throat, PA, based on your prepaid estimate.

What if I have questions about my statement?

If you have questions about a statement you receive from CornerStone Ear, Nose & Throat, PA, please call the Business Office at 704/289-8220. If you have questions concerning any other statement, please call the number on the statement you received from that party.

Why will I receive other statements?

When having surgery or a procedure in the office, there may be multiple parties involved in providing part of that care. For example, you may receive separate bills for pathology or lab work related to your visit and/or subsequent surgical procedure. These are billed separately to your insurance company and you will receive separate statements from each of these parties, if applicable.

My insurance explanation of benefits says that I had surgery in your office. What does this mean?

If you had a procedure done in the office, like a biopsy, nasal endoscopy or tube placed in your ear, these are considered surgical procedures and will be billed to your insurance company accordingly.