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.
I just scheduled surgery. Whose responsibility is it to notify me of my benefits?
Patients (or their guardians) are responsible for knowing the requirements of their insurance plans, including any authorizations or precertifications that may be required. However, as a courtesy to our patients, our staff checks patient eligibility and benefits, but this information is limited to information available at the time the benefits are checked.
Will my insurance cover my surgery?
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 the financial responsibility of the patient/guardian.
How will I know if my surgery is approved?
As a courtesy, our business office will verify insurance coverage and authorization and will notify you if there are issues preventing prior approval of your procedure. However, the responsibility for obtaining this precertification and paying our fees lies with 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.
When will I know how much I have to pay for my surgery?
As a courtesy to our patients, if requested our staff will provide an estimate of your financial responsibility. You will also receive this information if your plan has a very high deductible or co-insurance. Any payment made to CornerStone Ear, Nose & Throat, PA, will be applied to our surgeon’s charges only. CornerStone Ear, Nose & Throat, PA, is not responsible for providing hospital or surgery center, anesthesia, or any other estimates related to your surgery. Please contact the hospital or surgery center for estimates and payment arrangements related to those charges.
When do I need to pay for my surgery?
Unless other arrangements are offered, you are required to pay the estimated responsibility at least three (3) days prior to your surgical procedure. At no time should you forego needed medical care because of financial concerns. Your health is our primary concern. If you anticipate a financial problem, please contact us at (704) 289-8220 and someone in our Business Office will be happy to discuss payment options with you. For your convenience, we accept MasterCard, Visa, and American Express cards.
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 information from your insurance carrier. This estimate is 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 are Assistant Charges?
In cases involving more complex procedures, your surgeon may require another surgeon to assist with the procedure. These assistant charges are billed separately and apart from the primary surgeon fees and will be processed accordingly by your insurance company. Your statement from CornerStone Ear, Nose & Throat, PA, will reflect these charges and any patient financial responsibility, if applicable.
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, there are multiple parties involved. Charges for the hospital or surgery center, anesthesia, and pathology are all billed separately to your insurance company and you will receive separate statements from each of these parties, if applicable