Insurance & Fees

Insurance policies vary greatly in their amount and type of coverage. The receipt that is given to you after your office visit has been designed to be used for insurance purposes. If requested, our office will help you complete your form at no charge. Please remember that your insurance is a contract between you and your insurance company. Please remember also that you are responsible for your medical bills regardless of your insurance coverage.

Our office does participate with many insurance plans and will file these on behalf of the patient. Please inquire when scheduling your appointment about whether our office participates with your insurance.

Our office participates with many HMOs and PPOs. If a referral form from your primary care physician is required, you must bring the referral to each appointment. Please let us know if you were referred to this office by another physician so that we can send him or her your medical evaluation.

Billing Information

Drs. Bianchi & Driscoll, P.A., Musgrove Ear, Nose & Throat, ASC and the Hospitals accept most major insurance plans. It is important to understand that your insurance company will be billed separately by the following professional services:

• Physician
• Facility (hospital or surgery center)
• Anesthesia (if indicated)
• Laboratory (if indicated)

Your insurance policy may require co-pays and/or deductibles that may apply to one or more of the services provided for your procedure. Please be aware that you may receive multiple “Explanation of Benefits” and bills from each provider.

Insurance companies will NOT guarantee payment when we call for authorization. However, you will be notified if they do not authorize the procedure or require it to be performed at a different location.

Each insurance policy provides different benefits. Please call your insurance company for explanations specific to your individual policy.

Basic Policy

Payment for services is due in full at the time the service is provided in our office. There will be a $50.00 fee for missed appointments and a $25.00 fee for returned checks.

For Patients with Insurance

We bill most insurance carriers for you if proper paperwork and a valid insurance card are provided to us prior to service. We will also bill most secondary insurance companies for you. Copayments and deductibles are due at the time of service. Since your agreement with your insurance carrier is a private one, we do not routinely research why an insurance carrier has not paid or why it paid less than anticipated for care. If an insurance carrier has not paid within 60 days of billing, professional fees are due and payable in full from you.

Medicare Patients

We will bill Medicare for you and will also bill most secondary insurances for you. All co-payments and deductibles are due and payable at the time service is provided.

Surgery Fees

All copays, deductibles and payments for non-covered surgical procedures are due prior to your surgery. Prior authorization may be required by your carrier. Additionally, there is a $150.00 fee to re-schedule surgical procedures.

Non-Covered Services

Any care not paid for by your existing insurance coverage will require payment in full at the time services are provided or upon notice of insurance claim denial.

Insurance & Fees

The following is the list of insurances with which we participate. This will be updated from time to time as needed:

• Aetna Commercial/Medicare
• Anthem BCBS
• Apostrophe
• CareFirst BCBS
• Cigna Healthcare
• HealthNet Federal Services (HNFS) Tricare
• Humana
• Humana Military Tricare
• Medicare – MD – Novitas
• Medicare – Novitas – DC/Surr. Counties
• Medicare – Novitas – DC/Surr. Counties – Revalidation
• Medicare – Palmetto GBA – VA
• Medicare – Palmetto GBA – VA – Revalidation
• Multiplan/PHCS
• Railroad Medicare DC
• Railroad Medicare Virginia
• United Healthcare
• University of Maryland Health Partners
• Virginia Health Network
• WebTPA – Custom Ink

*Medicaid participation is optional and varies amongst Privia Medical Group providers – please verify participation prior to your visit.

**Maryland ENT Associates does not take the MMA plan.

Note: You should always check with your Privia Medical Group provider to verify plan and product coverage as this is not an exhaustive list, and plans change frequently.

Payment Options

We accept cash, Visa, Mastercard, Discover, American Express, and personal checks.

Card-on-File

We encourage patients to keep a credit card on file to make the checkout process easier, faster, and more efficient. You will no longer receive statements from us, but you will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, detailing the charges and payments made on your behalf.

At check-in we will:

• scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card

After your insurance has paid their portion, we will:

• notify you via email of the balance owed
• charge the balance owed to your card on file
• email a receipt for the charge

Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).

Fees