FOR EXISTING PATIENTS: Use the form below to request a personalized, non-binding estimate of your out-of-pocket cost for a sinus procedure. In most circumstances your health plan will not provide us with this document. Provide your insurance and benefit details and our office will review your information and follow up with your estimate. Estimates will be sent by email or text. We do not call with estimates.
You will need:
(1) access to your SBC (Summary of Benefits and Costs) document information for your health plan. You access this document by logging into your Member Portal for your insurance and accessing the link for plan documents/SBC.
(2) Access to the amount of your unmet deductible at the time of running the estimate.
(3) Access to the amount of your unmet out-of-pocket-max at the time of running the estimate.
Alternative methods of accessing this SBC are by calling member services—the phone number should be on the back of your card. Under ACA, your employer must furnish the SBC free on request if you get your insurance through work.
Disclaimer: This is a non-binding estimate, not a guarantee of coverage, payment, medical necessity, or final patient responsibility. The final bill may differ based on eligibility, benefits on the date of service, payer rules, coding edits, prior authorization, site of service, anesthesia/facility fees, and services actually performed. Your estimate will be reviewed by the office prior to forwarding using the contact information provided. Thank you!