{"id":361,"date":"2018-02-14T03:38:00","date_gmt":"2018-02-14T10:38:00","guid":{"rendered":"http:\/\/www.nwamemorialent.com\/site\/?page_id=361"},"modified":"2023-06-19T07:36:42","modified_gmt":"2023-06-19T14:36:42","slug":"insurance","status":"publish","type":"page","link":"http:\/\/www.nwamemorialent.com\/site\/patientresources\/insurance\/","title":{"rendered":"Forms & Insurance"},"content":{"rendered":"

Our office hours are Monday-Friday 8:00am – 5:00pm.\u00a0 If you have any questions regarding the information below, please call our office at 479-439-6110.<\/p>\n

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Forms<\/h3>\n

New Patient Forms & Notice of Privacy Practices<\/a><\/p>\n

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Insurance<\/strong><\/p>\n

We accept most major insurance policies. We recommend that each patient verify details of coverage with their insurance company per their specific policy.\u00a0 If your insurance plan requires a referral, please contact your primary care physician and request that a referral be sent to our office directly.\u00a0 Failure to obtain a referral when required may result in non-payment by your insurance company.<\/p>\n

Payments for services are due at the time services are rendered unless prior arrangements are made with the office manager.\u00a0 First time patients must pay office visit charges and established patients will need to pay either their deductible or co-insurance amounts due.\u00a0 If we are in a contract agreement with your insurance company and you have a specialist co-payment allowed amount, then that amount can be paid.\u00a0 As a reminder, not all co-payments apply to specialist.\u00a0 Please check with your insurance concerning this prior to services.<\/p>\n

As a courtesy to our patients we file most primary insurance carriers.\u00a0 If you wish to file the claim yourself, please advise the front office staff prior to being seen.\u00a0 If for some reason we cannot file your insurance claim, we will send you a standardized insurance form in the mail within 7 to 10 business days for you to forward to your insurance carrier.<\/p>\n

We attempt to file most secondary insurance carriers except Champus\/Champva\/Tricare.\u00a0 If for any reason we cannot file with your secondary insurance company, we will send you the claim form to file with them upon your oral or written request.\u00a0 You will need to attach our form to a copy of your primary insurance carrier’s Explanation of Benefits and mail it to your secondary insurance carrier.\u00a0 There is a charge for any reprints of insurance forms.<\/p>\n

However, you must understand that:<\/p>\n

    \n
  1. Your insurance policy is a contract between you, your employer and the insurance company. We are NOT a party to that contract, our relationship is with you, not your insurance company.<\/li>\n
  2. All charges are your responsibility whether your insurance company pays or not. Not all services are a covered benefit in all contracts. Some insurance companies arbitrarily selected certain services they will not cover.<\/li>\n
  3. Fees for surgery (ies), along with unpaid deductibles and co-payments are due prior to surgery date.<\/li>\n
  4. If the insurance company does not pay your balance in full within 60 days from the date services were rendered, we require that you pay the balance due or make regular monthly payments on your account.<\/li>\n
  5. Returned checks are subject to a S25 NSF fee. Balances older than 60 days past due without a regular monthly payment will be subject to interest charges of .50 per month to help cover postage<\/li>\n
  6. Over-payment or refunds will be mailed back to the patient after a 10 business day waiting period. Amounts under $5 will be applied as a credit to the patients account<\/li>\n
  7. Be aware that certain procedures may not be included in your Office Visit co-pay\/allowed amount and will be an additional charge. These include but are not limited to: video scope of the nose\/throat, hearing test, nasal cautery\/pack, biopsy, \u00a0and foreign body removal<\/strong><\/li>\n<\/ol>\n

     <\/p>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Our office hours are Monday-Friday 8:00am – 5:00pm.\u00a0 If you have any questions regarding the information below, please call our office at 479-439-6110. Forms New Patient Forms & Notice of Privacy Practices Insurance We accept most major insurance policies. We… Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":347,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/pages\/361"}],"collection":[{"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/comments?post=361"}],"version-history":[{"count":12,"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/pages\/361\/revisions"}],"predecessor-version":[{"id":670,"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/pages\/361\/revisions\/670"}],"up":[{"embeddable":true,"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/pages\/347"}],"wp:attachment":[{"href":"http:\/\/www.nwamemorialent.com\/site\/wp-json\/wp\/v2\/media?parent=361"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}