Welcome To Florida Otolaryngology Group, P.A.

Checking in as a new patient is now easier than ever! With our integration of the new Phreesia check in software, you can have your information in our system before you even step foot in our office. When you schedule your new patient appointment make sure to give your email address. An email will be sent 3 – 4 days prior to your appointment with instructions on how to submit your personal and medical information from your PC or smart phone.

The following are office polices that should be reviewed prior to your appointment. For your convenience we have included new patient forms below:

To provide quality care, we request new patients bring any medical records from their primary care physician that pertain to their ear, nose or throat problem. Please bring any films from a CT scan, X-ray, or MRI, as well as a list of your current medications.
All minors must be accompanied by a parent or legal guardian for every visit. If you are a legal guardian, you must bring supporting documentation.
Please confirm we are providers for your insurance plan. Our staff will do their best to let you know if our doctors are out-of-network for your plan. However, it is your responsibility to know your insurance plan.
Always bring your insurance card to your appointment. If our staff cannot verify insurance coverage at the time of your appointment, the visit will be considered self-pay and full payment will be expected at the time of service.
If your health insurance requires a referral from a primary care physician, your appointment will be cancelled if we have not received authorization by your appointment time.
Our doctors may require tests and/or diagnostic procedures in order to care for your health. Depending on your insurance coverage, these may require an additional co-payment or deductible.

A doctor patiently explaining to the patient about possible tests.

Forms

Release Of Medical Records

Use this form to request your records to be faxed or mailed to another party or yourself. To ensure our staff can process your request accurately, please fill out the form completely and allow 48 hours to process.

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Notice Of Privacy Practices

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information.

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Insurance

Florida Otolaryngology Group P.A. Accepted Insurance Carriers

Aetna HMO/POS/PPO/Premier Care
Aetna Better Health (Children only)
Allegiance (Disney/Orlando Health)
AvMed
Blue Cross Blue Shield Florida (Not the Florida SimplyBlue plans)
CarePlus
Clear Health Alliance
ChampVA
Cigna HMO/POS/Open Access/PPO/Local Plus/ HealthSpring/ Central Florida Network (Not Cigna/Disney Florida Hospital plans or Cigna SureFit/Advent Health)
Coventry PPO
Employers Health Network (Orlando Health)
First Health
Florida Blue (Not the Florida SimplyBlue plans)
Freedom Health
HealthChoice PPO/Select
Humana HMO/HMO Select/HMO Premier/PPO/POS
Humana Medicaid (Children only)
Imagine Healthcare
Medicaid (Children Only: Orange Co, Seminole Co, Osceola)

Medicare
Multiplan PPO
National Association of Preferred Providers
National Preferred Providers Network
Orlando Health (HealthChoice)
Optimum
Preferred Care Partners (WellMed)
Private HealthCare Systems POS/EPO/PPO
Simply Healthcare (Children only)
Sunshine (Under 21 only)
Tricare Standard
Tricare Prime
United Healthcare POS/PPO/Compass/Navigate/Nexus (Not the Neighborhood Health plans)
United Healthcare AARP Medicare Replacement Plans
United Healthcare Medicare Advantage/Dual Complete
United Healthcare Medicaid
VA – Veterans Administration
WellMed HMO/PPO
Wellcare HMO/PPO/POS

For insurance that we are not contracted providers for: Charges will apply to your out of network benefits.

What are Specialists?

Otolaryngology physicians are “specialists”. Specialists are physicians who are experts in a particular branch of medicine. Based on your insurance policy, you may be responsible for a larger co-payment for specialist office visits. This information may or may not be included on your insurance card. If you have any questions regarding your co-pays, please contact your insurance carrier.

Understanding Medical Billing

Florida Otolaryngology Group, P.A., is contracted with many different insurance plans. If we are a contracted provider for your health insurance plan, our office will file your medical claims. Also, as a member of a health insurance plan, you are most likely entitled to a discount.

The remaining charges are considered our “allowed amounts.” You are financially responsible for any part of the allowed amounts not paid under your policy. Be aware that although our services may be “covered” by your insurance carrier, your insurance may require you to pay a co-pay, co-insurance, or deductible before they pay the remaining charges.

A common misconception is that health insurance plans are responsible for a patient’s medical bills. In truth, consumers are responsible for their medical debts. Your contract with your insurance carrier determines how much of your services they will cover; however, you are ultimately responsible for your medical bills. Medical office visit charges can vary. Charges are based on the type of visit and the complexity of the exam.

The physician will determine the appropriate level of service at the time of your exam. In addition, our physicians may perform diagnostic procedures or testing in order to care for your health. Depending on your insurance coverage, these may require an additional co-payment, co-insurance, or deductible. We will do our best to let you know if we are in-network for your insurance carrier; however, it is your responsibility to know your insurance plan. If our office cannot file your claim due to inaccurate information (incorrect ID#s, incorrect date of birth, old insurance information, etc.), you will be responsible for the full charges.

Authorizations

Many HMO plans require the patient to receive a referral from their primary care physician before receiving services from another provider. Depending on the insurance plan, this could be a simple note or script recommending the patient visit an ENT (Ear, Nose, and Throat physician), or a detailed referral that includes a specific physician, diagnosis, and authorization number.

Although our staff will try to assist in confirming that a referral has been issued, it is the patient’s responsibility to obtain authorization from their PCP.

Co-Pay

Many insurance plans require a patient to pay a fixed amount toward every physician’s visit. In most cases this co-payment will be the same regardless of the extent of the services provided; however, there are a couple of notable exceptions. Otolaryngology physicians are “specialists”. Specialists are physicians who are experts in a particular branch of medicine. Based on your insurance policy you may be responsible for a larger co-pay for specialist office visits. This information may or may not be included on your insurance card.

Our physicians may perform diagnostic procedures in order to care for your health. These procedures are often invasive and are considered surgical by the American Medical Association and your insurance carrier. Depending on your insurance coverage, the procedures may require a higher co-payment than listed on your insurance card.

Our office policy is to collect your copay at check-in. The amount collected is based on the information we have at that time. If your insurance company notifies us that a larger co-payment was due, you will be billed for the difference.

Co-Insurance

Some health insurance plans require a patient to pay a percentage of their medical bills. As an example, a 20/80 plan would require a patient to pay 20% of the total allowed charges. The insurance plan would pay the remaining 80%.

Generally, our office will bill the patient their exact co-insurance after an insurance company has processed the claim. We may require a payment toward your co-insurance for pre-planned services, such as surgery. In these incidents, our staff will determine your estimated responsibility as accurately as possible.

Deductible

Some health insurance plans require the patient to pay a deductible. Your deductible is the amount you are responsible for paying yearly before the insurance company pays toward your bills. Insurance policies vary regarding deductibles. Some plans require a deductible for all services; others only require a deductible on surgical procedures. Our physicians may perform diagnostic procedures in order to care for your health.

These procedures are often invasive and are considered surgical by the American Medical Association and your insurance carrier. Depending on your insurance coverage, you may owe a deductible for these services, even if you would not owe a deductible for an office visit.

Generally, our office will bill the patient their deductible after an insurance company has processed the claim. We may require a payment toward your deductible for pre-planned services, such as surgery. In these incidents, our staff will determine your estimated responsibility as accurately as possible.

General information regarding procedures

Depending on your insurance coverage, these may require an additional co-payment or deductible.

Post-operative Visits

Most surgical procedures that are performed in an out-patient surgical facility have a post-op period. This period may extend from 10 to 90 days. Although there are no charges for your exam, there are charges for any procedures (such as a sinus debridement) or testing required during your post-operative care. A physician may want to follow-up beyond the normal post-op period. Normal office visit charges may apply.

If you are treated by a physician for reasons not related to your surgery in this time frame, normal visit charges may apply.

Appointment for throat concerns

Our physicians strive to provide quality medical care. In order to properly diagnose your throat problems, your physician may need to perform a flexible laryngoscopy or another diagnostic scope exam. This office procedure and other similar procedures use a scope to view inside your throat.

These are considered diagnostic surgical procedures by both the American Medical Association and your insurance carrier.

Based on your insurance coverage, you may owe an additional co-pay or deductible for surgical procedures. If you have any questions regarding your insurance benefits, please check with your insurance carrier.

Appointment for sinus concerns

Our physicians strive to provide quality medical care. In order to properly diagnose your sinus problems, your physician may need to perform a sinus endoscopy or other diagnostic scope. This office procedure and other similar procedures use a scope to view your sinuses.

These are considered diagnostic surgical procedures by both the American Medical Association and your insurance carrier. Based on your insurance coverage, you may owe an additional co-pay or deductible for surgical procedures. If you have any questions regarding your insurance benefits, please check with your insurance carrier.

Appointment for hearing concerns

Our physicians strive to provide quality medical care. In order to properly diagnose your hearing problems, your physician may order an audiometric evaluation. These tests are for diagnostic purposes and are not considered “screening” tests.

Audiologic testing is generally covered by your insurance carrier; however, your policy may contain limitations. If you are unsure of your coverage, please contact your insurance carrier.

Ready To Book Your First Appointment?

The staff at Florida Otolaryngology Group, P.A., is here to provide friendly and efficient service. Every detail counts when dealing with patient care, which is why we take the time to verify insurance approvals and check-in patients quickly and efficiently.

Schedule An Appointment