Questions About My Bill. – Alabama Nasal & Sinus Center

Health care is changing. That’s not news, but these changes are affecting physicians and patients on a daily basis. It has become increasingly important for patients to understand how their insurance works for them and what their responsibilities are related to deductibles. Many patient’s deductibles have increased so that their payment responsibilities at the point of service may be higher than the usual copays to which they are accustomed.

As ear, nose, and throat specialists at the Alabama Nasal and Sinus Center we often employ certain procedures such as nasal endoscopy and flexible endoscopy of the throat and voice box. These procedures are separately reported and billed so that your explanation of benefits will show a “surgical procedure”charge. Depending on your deductible, part or all of the allowable fee for these services may be your responsibility. This may be in addition to your copay. Admittedly, this is confusing. We are always happy to discuss this issue with you if you have questions.

Another confusing issue is how charges are billed for post-operative care. For most surgical procedures we perform, post-operative care is included in the global fee. Typically there is no charge for after surgery visits for up to 90 days after tonsillectomy, ear tubes, and septoplasty, for example. Sinus surgery is an exception. The global period for endoscopic sinus surgery is zero days. In other words, post-operative care after sinus surgery is billed as a separate encounter, beginning the day after surgery. When you come for an office visit after sinus surgery, you will be responsible for the copay as well as any portion of the nasal endoscopy with debridement for which your deductible has not been met. The rules governing global periods are decided by the Centers for Medicare and Medicaid (CMS) and/or by your insurance company, not the Alabama Nasal and Sinus Center! Once again, this is confusing, but we are happy to answer any question you have related to billing.

I am a general otolaryngologist who specializes in diagnosis and treatment of diseases affecting the ears, nose, and throat. Though I treat patients in all areas of otolaryngology, of all ages, I have special interests in rhinology, otolaryngic allergy, pediatric otolaryngology, and head and neck cancer.

I was born in Dothan, Alabama and spent my first two years in Troy, where my parents were completing school. Most of my early childhood and adolescence was spent in Pace, Florida, just East of Pensacola. I left home after graduating from Pace High School to attend the University of Florida. While there, I became very involved in various student leadership activities and even found time to play football for the Gators under Coach Spurrier. I loved college so much, I got two degrees and spent another two years in Gainesville while my new bride finished her degree in health science education. I am proudly married to the charming and beautiful Simone, mother of our three wonderful children.

I was pleased to get back to the Gulf Coast for a while when the University of South Alabama accepted me into their medical school. Those four years were some of the most intense and most fondly remembered years of my life. I started my training in otolaryngology – head and neck surgery at the University of Alabama Birmingham in 2001. I completed residency training in 2006 and began working in private practice in Valdosta, Georgia. It was while training at UAB that I met Dr. Michael Sillers. It is my great privilege to call Dr. Sillers my mentor and friend. We have known each other for over a decade now, and I am absolutely thrilled to have the opportunity to join Dr. Sillers and the Alabama Nasal and Sinus Center in providing the best in otolaryngology care to the people of Birmingham and surrounding areas.