Frequently Asked Questions (FAQs)

Here is a list of 'Frequently Asked Questions'...

Q: I have a question of a clinical matter (e.g. medication, prescription renewal, treatment options, current conditions). Can you help?
A: Unfortunately this site is not equipped to handle such requests. Please call your physician’s office directly.
 
Q: With which insurance plans do you participate?
A: All of our physicians participate with Medicare. As far as private insurance is concerned, not all of our doctors participate in the same plans. Please go to our "Physicians by Name" or our "Physicians by Insurance Carrier" pages for current information.
 
Q: The doctor I want to see does not participate with my insurance. What can be done?

A: If you have out of network benefits we will assist you in billing your insurance. Please contact the Practice Site Administrator at the location of your choice for full details.

You can also contact your insurance company to see if they can make a “network exception” for your care. With such an authorization from your plan, you could see a non-participating doctor and only have to pay your in-network co-payment.

If you do not have out of network benefits or an exception from your insurance plan, please contact the Practice Site Administrator at the physician’s office to obtain details about direct payment.
 
Q: I did not have surgery. Why is a surgery listed on my explanation of benefits?

A: A number of procedures are performed by our doctors for diagnostic purposes. Two common examples are sinus endoscopies and fiberoptic laryngoscopies. These allow the physicians to more precisely diagnose and treat your conditions.

All procedures are assigned a code, and the description of these procedures, according to the correct code, is that of a diagnostic nature. These procedures, however, are only found in the coding section that is reserved for surgery and as such, insurance companies report them inappropriately as surgery. This creates confusion as no surgery was performed but the billing procedure is correct.
 
Q: I already paid my co-payment for the date of service on my statement. Why am I being billed for this again?

A: There are several possibilities:

1) You had a previous visit with an open balance and your payment was applied to that older balance.

2) Another member of your family, for whom you are the guarantor, had an older open balance and your payment was applied there.

3) Our payments are not usually posted to your account on the same day you pay them. If the date of the statement is close to the date of your payment, it is possible that they crossed in the mail.

4) Your insurance company required an additional co-pay. Some insurance companies (e.g. GHI, POMCO, Empire Plan) require an additional co-pay for certain diagnostic procedures. This is a requirement put into place by your insurance carrier, not by ENT and Allergy Associates

If none of these answers seem to apply, please send your payment receipt or copy of cancelled check to PO Box 5001, White Plains, NY 10602-5001, fax to 914-333-2545, or email Questions@ENTandAllergy.com.