Financial Policy

Charleston ENT & Allergy
The Surgery Center of Charleston

Patient Registration

  • You will be asked to complete a registration form each year and update and/or confirm the accuracy of this information at every visit.
  • For your protection, we require personal identification. Bring your driver??s license or picture ID on every visit or front office check in system.
  • Our registration form is available on our website.

Cancellation & No Show Policy

  • We require 24 hour notice if you wish to cancel and reschedule your appointment.
  • A $35.00 fee will be charged for no show or late cancellations.
  • A nonrefundable $50.00 security deposit will be required to make an appointment for patients who frequently no show.

Insurance Cards & Insurance Filing

  • As a courtesy to all our patients, we will file insurance claims to your primary and secondary insurance carrier.
  • You must bring your current insurance card to every visit to file insurance claims on your behalf. It is your responsibility to inform us in a timely manner of any changes to your billing information.
  • If an insurance company denies payment for incomplete or incorrect information provided by you or for noncovered services, you will be expected to pay for services in full.
  • If we do not participate in your insurance plan, be aware your benefits may be reduced.
  • We do not file school or automobile insurance.
  • We do not participate in any hospital affiliated Charity Programs.

Insurance Authorization

  • If your insurance requires an authorization for office visits or procedures, it is your responsibility to make sure we have authorization prior to the visit or service.
  • If you want to be seen without an authorization, you will be considered a self pay patient and required to pay in full for all services.


  • Our physicians are Board Certified and use the latest diagnostic technologies to effectively diagnose and treat problems of the ear, nose, and throat.
  • During your visit, you may undergo diagnostic testing for a complete ENT evaluation of your problem.
  • Patients with sinus problems may have a nasal endoscopy procedure performed at their visit.


  • We accept Cash, Check, Money Order, Visa, MasterCard, Discover and American Express.
  • Patients are expected to pay for all estimated co-pays, deductibles and coinsurance at the time of service as required by your insurance company.
  • Patients may also receive a monthly statement for any unpaid services by patient or insurance.
  • Returned check fee of $25.00
  • Medical record fee of $25.00 in advance for completion of disability forms.

Self Pay

  • It is impossible to determine what the cost of the care will be prior to the date of service.
  • We require a minimum payment of $200.00 up front prior to seeing the doctor for new self pay patients.
  • Additional payment may be required at time of checkout for services rendered.
  • Patients who do not have insurance will receive a 20% discount on charges if paid in full on date of service.
  • Patients will be billed for any balance not paid at checkout due upon receipt of statement.

Liability & Workers Compensation

  • We require written authorization by your employer or workers compensation carrier PRIOR to your visit. If you claim is denied, you are responsible for payment in full
  • We do not accept assignment in the case of liability/legal actions.
  • Payment of the bill is the responsibility of the person receiving treatment

Minor Patients

  • Patients under the age of 18 must be accompanied by the parent or guardian.
  • The parent who consents for treatment will be the responsible party on the account and is responsible for all charges regardless of divorce or separation decree.
  • We request patients age 18 or older covered under their parents insurance to sign an authorization allowing Charleston ENT & Allergy to contact parents regarding insurance and billing issues.

Pre-surgical Deposits

  • All patients are expected to pay a deposit prior to surgery. Please refer to our Surgery Financial Policy.

Extended Payment Plans & Financial Assistance

  • Please call our billing office to discuss any extended payment plan options.

Termination/Discharge from Practice

  • The following scenarios may jeopardize the patient/physician relationship in which Charleston ENT & Allergy will terminate and discharge the patient from the practice. The patient will be sent a letter of discharge.
    • Noncompliance/Abusive Patients
    • Excessive no shows
    • Failure to meet financial obligations.