Alabama Nasal & Sinus Center

Alabama Nasal & Sinus Center

Questions About My Bill.

st-vincentHealth care is changing. Thats not news, but these changes are affecting physicians and patients on a daily basis. It has become increasingly important for patients to understand how their insurance works for them and what their responsibilities are related to deductibles. Many patient’s deductibles have increased so that their payment responsibilities at the point of service may be higher than the usual copays to which they are accustomed.

As ear, nose, and throat specialists at the Alabama Nasal and Sinus Center we often employ certain procedures such as nasal endoscopy and flexible endoscopy of the throat and voice box. These procedures are separately reported and billed so that your explanation of benefits will show a “surgical procedure”charge. Depending on your deductible, part or all of the allowable fee for these services may be your responsibility. This may be in addition to your copay. Admittedly, this is confusing. We are always happy to discuss this issue with you if you have questions.

Another confusing issue is how charges are billed for post-operative care. For most surgical procedures we perform, post-operative care is included in the global fee. Typically there is no charge for after surgery visits for up to 90 days after tonsillectomy, ear tubes, and septoplasty, for example. Sinus surgery is an exception. The global period for endoscopic sinus surgery is zero days. In other words, post-operative care after sinus surgery is billed as a separate encounter, beginning the day after surgery. When you come for an office visit after sinus surgery, you will be responsible for the copay as well as any portion of the nasal endoscopy with debridement for which your deductible has not been met. The rules governing global periods are decided by the Centers for Medicare and Medicaid (CMS) and/or by your insurance company, not the Alabama Nasal and Sinus Center! Once again, this is confusing, but we are happy to answer any question you have related to billing.

Balloon Sinuplasty - Part II
Is balloon sinuplasty for me?