Financing / Billing Policy

In cases of HMO insurance plans, you required to have a referral.  If you have HMO coverage, we would encourage you to phone us in advance of your appointment date to confirm that we have received your referral.  If you arrive without a referral, we will allow you time to call your primary care provider to try to get one faxed to us expediently, but this might delay your appointment.  If you are unable to obtain the referral, you may pay out of pocket for the visit, or reschedule the visit to a later date.  In cases of Medicare Part B, then Medicare requires a referral or note requesting for our office to “evaluate and treat” from your primary care provider in order for Medicare to cover services provided by an audiologist.

Which insurance plans are AHBC contracted with?
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We contract with most carriers. To confirm that we take your insurance, please review our list of Accepted Insurance Plans here.

Does AHBC charge for no-showing an appointment?
On the first no-show occurrence there will be a $25 charge to your account.

Does AHBC charge interest on outstanding balances?
We do not charge interest.

What is my financial responsibility for services provided by AHBC?
This is dependent upon your insurance plan and several other factors, as outlined below:

• Private Pay (ie. Patients without any insurance coverage): Payment at the time of service is expected/required.  We do offer a discount to patients who pay for their services in full at the time services are rendered.

• Medicare Part B: We are participating providers with Medicare currently.  We do accept a secondary policy if it is a Medigap policy and Medicare automatically forwards the claim.  You will be required to pay your Medicare deductible at the time of service and any coinsurance.

• Workers Compensation: We DO ACCEPT Worker’s Compensation patients as an ancillary provider. We will check with your workers comp carrier to determine if pre-authorization is required prior to your appointment.

• Medicaid: We DO NOT accept Medicaid at this time.

• Contracted Managed Plans (HMO/PPO/POS, etc): All applicable copay and deductibles are required at the time of the office visit.  If you are scheduled for a diagnostic procedure, we will perform an estimate of your out-of-pocket cost (copay, coinsurance, and/or deductible).  Our scheduler will attempt to contact you prior to your appointment and inform you of these costs, and will calculate the amount to be collected when you arrive for your appointment. If the procedure is not covered by your plan, we will request payment in full.

• Indemnity/Fee for Service: As a courtesy to our patients, we will file a claim to their insurance provided they have met their annual deductible and pay their coinsurance at the time of service.  If the patient has not met the annual deductible, we will estimate your coinsurance payment and provide this information to you.  Payment is expected at the time of service, and our office will file a claim with your insurance upon request.

Please be aware that a procedure may need to be performed such as wax removal or canalith repositioning maneuvers as part of your office visit. These procedures will be billed separately and in addition to office visit charges.  We have become aware that some insurance carriers are classifying these procedures as non-covered services by an audiologist and will apply them as the patient responsibility.  The result may be insurance payment for an office visit, but not a procedure.   In such cases, payment for the procedure will be due from the patient.  Be assured that we are following accepted billing and coding guidelines and that all procedures are performed in the best interest of patient care.

You will be charged a return check fee of $35 to redeem the check.  If the check is not paid within 10 days, it will be turned over to Collin County District Attorney’s office (Hot Checks Division) for collection.

If after reasonable efforts are made by the Practice to collect payments for services and such efforts are unsuccessful, the Practice reserves the right to refer the patient to collections.
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To assist with this process, our staff will see that:
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1. All Insurance cards are scanned.
2. All Insurance cards are verified at every visit.
3. All co-payments, deductibles, coinsurance and payment for non-covered services are collected at either check-in or check-out.
4. Insurance is verified prior to patients checking out.
5. Necessary referrals have been received and are current prior to the patient visit.
6. Hearing aid deposits are collected at the time of ordering.

In the event of an overpayment on a patient’s account, as determined by the insurance carrier or as a result of patient payment, a refund check will be issued by Advanced Hearing & Balance Center to either the patient, or in the case of a minor patient, to the individual who signed as the financially responsible party on the financial statement for the visit for which the overpayment exists. All insurance claims must be finalized on the patient account before a refund may be issued. All open invoices must be paid in full before a refund may be issued. The refund will be issued back on the credit or debit card initially used. Any check in the amount of the overpayment will be mailed to the address listed on the registration form or in the case of a minor patient, to the address provided by the financially responsible party at the time of the minor patient’s visit.  A minor is defined as 17 years of age or younger.