POLICIES
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Patient Rights:
You have the right to prompt and adequate response to reasonable request and needs for treatment or services, within our capacity.
You have the right to choose a healthcare provider who can give you high quality health care when you need it or to refuse examination or care by a specific healthcare professional. You have the right to refuse to participate in experimental research.
You have the right to accurate and easily understood information about your health plan, healthcare professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help will be provided so you can make informed health care decisions.
You have the right to information regarding services available at ENT Center of Northwest Alabama and the cost of these services.
You have the right to know your treatment options and to take part in decisions about your care. Parents, guardians, family members, or others that you select can represent you if you cannot make your own decisions.
You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.
You have the right to talk privately with health care providers and to have your health care information protected. You also have the right to a copy your own medical record. You have the right to ask that your doctor document in your records any corrections to inaccurate, irrelevant, or incomplete information.
You have a right to a fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals or other health care personnel. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy of the health care facility.
You have the right upon request to receive a copy of any itemized bill or statement of your charges.
You have the right to after-hours contact numbers. You may contact a nurse after hours at 265-415-8100. If a medical emergency arises always dial 911
You have a right to review our payment policy for all services rendered.
You have a right to review all credentials for the facility and for healthcare professionals.
Patient Responsibilities:
You are responsible for providing complete and accurate information to the best of your ability about your health, any medications, including over the counter products and dietary supplements, present complaints, past illnesses, hospitalizations, advanced directives, power of attorney, or other directive that could affect your care, any allergies or sensitivities, and other matters relevant to health or care.
You are responsible for keeping all appointments or contacting the office at least 2 weeks prior to your appointment to cancel.
You are responsible to inform ENT Center of Northwest Alabama promptly if you do not understand any matter relating to your care and treatment or instructions with which you cannot comply.
You are responsible to follow the treatment plan prescribed by your provider.
You are responsible to be considerate to other patients and to see that any person with you is considerate, particularly with reference to noise.
You are responsible for providing a responsible driver to transport you home and remain with you for 24 hours following your procedure (or longer, if required by your physician).
You are responsible to observe the smoke-free policy at our office.
You must accept personal financial responsibility for any charges for services rendered at ENT Center of Northwest Alabama and for any charges not covered by insurance if insurance is billed.
You are responsible to provide necessary information regarding coverage of your charges.
You must be respectful to all the health care providers and staff.
You are responsible for your actions if you refuse treatment or do not follow your provider’s instructions.
You are responsible for all products purchased at ENT Center of Northwest Alabama and understand that these may be prescription products, which are by state law nonrefundable.
Revised: 7/21/21
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Welcome to www.entcenteralabama.com (the “Website”) an offering of the ENT Center of Northwest Alabama LLC (the “Practice”, “we” or “us”). These terms of use are entered into by and between you, the user of this Website (“you” or “your”) and the Practice. The following terms and conditions (these “Terms of Use”) govern your access to and use of the Website, including any content, functionality, and services offered on or through the Website. Please read the Terms of Use carefully before you start to use the Website. By using the Website, you accept and agree to be bound and abide by these Terms of Use, our privacy policy regarding health information found at www.entcenteralabama.com/privacy (the “HIPAA Policy”), and our privacy policy for the Website found at www.entcenteralabama.com/privacy (the “Website Privacy Policy”).
If you do not agree to these Terms of Use, our HIPAA Policy, or our Website Privacy Policy, you must not access or use the Website. This Website is offered and available to users who are 18 years of age or older. By using this Website, you represent and warrant that you are 18 years of age or older and of legal age to form a binding contract with the Practice. If you do not meet this requirement, you must not access or use the Website. Further, in compliance with the Children’s Online Privacy Protection Act (“COPPA”), this Website and the collection of data through this Website are not offered nor available to users who are 13 years of age or younger. By using this Website, you further represent and warrant that you are not below the age of 13. If you do not meet this requirement, you must not access or use the Website.
Changes to the Terms of Use
We may revise and update these Terms of Use. All changes are effective immediately when we post them and apply to all access to and use of the Website thereafter. Your continued use of the Website following the posting of revised Terms of Use means that you accept and agree to the changes. You are expected to check this page from each time you access this Website so you are aware of any changes, as they are binding on you.
Accessing the Website and Account Security
We reserve the right to withdraw or amend the Website, and any service or material we provide on the Website, in our sole discretion without notice. We will not be liable if for any reason all or any part of the Website is unavailable at any time or for any period. From time to time, we may restrict access to some parts of the Website, or the entire Website, to users, including registered users. You are responsible for: making all arrangements necessary for you to have access to the Website and ensuring that all persons who access the Website through your internet connection are aware of these Terms of Use and comply with them. To access the Website or some of the resources it offers, you may be asked to provide certain registration details or other information. It is a condition of your use of the Website that all the information you provide to Practice through the Website is correct, current, and complete. You agree that all information you provide to register with this Website or otherwise, including but not limited to through the use of any interactive features on the Website, is governed by our Website Privacy Policy and/or HIPAA Policy, and you consent to all actions we take with respect to your information consistent with our HIPAA Policy and our Website Privacy Policy. We have the right to disable or delete any username, password, or other identifier, whether chosen by you or provided by us, at any time in our sole discretion for any or no reason, including if, in our opinion, you have violated any provision of these Terms of Use. Notwithstanding the forgoing, if your username, password, or other identifier used by you to access the website has been provided to you by the Practice as a means for accessing your medical records we shall take reasonable steps to make this information available to you upon your request, as required by law and consistent with our HIPAA Policy.
Intellectual Property Rights
The Website and its entire contents, features, and functionality (including but not limited to all information, software, text, displays, images, video and audio, and the design, selection, and arrangement thereof), are owned by the Practice, its licensors, or other providers of such material and are protected by United States and international copyright, trademark, patent, trade secret, and other intellectual property or proprietary rights laws. These Terms of Use permit you to use the Website for your personal use only. You must not reproduce, distribute, modify, create derivative works of, publicly display, publicly perform, republish, download, store, or transmit any of the material on our Website, except as follows:
Your computer may temporarily store copies of such materials in RAM incidental to your accessing and viewing those materials;
You may store files that are automatically cached by your Web browser for display enhancement purposes.
If we provide social media features with certain content, you may take such actions as are enabled by such features.
You may not print, modify, or download any materials (including any illustrations, photographs, video, or audio) from the website other than these Terms of Use, the Website Privacy Policy, the HIPAA Policy, and information provided to you directly by the Practice directly related to your health information or payment information. You may not delete or alter any copyright, trademark, or other proprietary rights notices from copies of materials from this site. You may not access or use for any commercial purposes any part of the Website or any services or materials available through the Website. If you print, copy, modify, download, or otherwise use or provide any other person with access to any part of the Website in breach of the Terms of Use your right to use the Website will cease immediately and you must, at our option, return or destroy any copies of all such materials you have made. No right, title, or interest in or to the Website or any content on the Website is transferred to you, and all rights not expressly granted in these Terms of Use are reserved by the Practice. Any use of the Website not expressly permitted by these Terms of Use is a breach of these Terms of Use and may violate copyright, trademark, and other laws.
Trademarks
The Practice name, the Practice logo, and all related names, logos, product and service names, designs, and slogans are trademarks of the Practice or its affiliates or licensors. You must not use such marks without the prior written permission of the Practice. All other names, logos, product and service names, designs, and slogans on this Website are the trademarks of their respective owners.
Prohibited Uses
You may use the Website only for lawful purposes and in accordance with these Terms of Use. You agree not to use the Website:
In any way that violates any applicable federal, state, local, or international law or regulation (including, without limitation, any laws regarding the export of data or software to and from the US or other countries).
for the purpose of exploiting, harming, or attempting to exploit or harm minors in any way by exposing them to inappropriate content (including any photographs, images, or videos on the website of a mature or explicit nature), asking for personally identifiable information or otherwise.
To send, knowingly receive, upload, download, use or re-use any material which does not comply with the Content Standards set out in these Terms of Use.
To impersonate or attempt to impersonate the Practice, a Practice employee, another user, or any other person or entity (including, without limitation, by using e-mail addresses or screen names associated with any of the foregoing).
To engage in any other conduct that restricts or inhibits anyone’s use or enjoyment of the Website, or which, as determined by us, may harm the Practice or users of the Website or expose them to liability.
Additionally, by using the site you agree not to:
Use the Website in any manner that could disable, overburden, damage, or impair the site or interfere with any other party’s use of the Website, including their ability to engage in real time activities through the Website.
Use any robot, spider, or other automatic device, process, or means to access the Website for any purpose, including monitoring or copying any of the material on the Website.
Use any manual process to monitor or copy any of the material on the Website or for any other unauthorized purpose without our prior written consent.
Use any device, software, or routine that interferes with the proper working of the Website.
Introduce any viruses, trojan horses, worms, logic bombs, or other material which is malicious or technologically harmful.
Attempt to gain unauthorized access to, interfere with, damage, or disrupt any parts of the Website, the server on which the Website is stored, or any server, computer, or database connected to the Website.
Attack the Website via a denial-of-service attack or a distributed denial-of-service attack.
Otherwise attempt to interfere with the proper working of the Website.
Monitoring and Enforcement; Termination
We have the right to:
Disclose your identity or other information about you to any third party who claims that material posted by you violates their rights, including their intellectual property rights or their right to privacy.
Take appropriate legal action, including without limitation, referral to law enforcement, for any illegal or unauthorized use of the Website.
Terminate or suspend your access to all or part of the Website for any reason, including any violation of these Terms of Use.
Without limiting the foregoing, we have the right to fully cooperate with any law enforcement authorities or court order requesting or directing us to disclose the identity or other information of anyone posting any materials on or through the Website. YOU WAIVE AND HOLD HARMLESS THE PRACTICE AND ITS AFFILIATES, LICENSEES, AND SERVICE PROVIDERS FROM ANY CLAIMS RESULTING FROM ANY ACTION TAKEN BY ANY OF THE FOREGOING PARTIES DURING OR AS A RESULT OF ITS INVESTIGATIONS AND FROM ANY ACTIONS TAKEN AS A CONSEQUENCE OF INVESTIGATIONS BY EITHER SUCH PARTIES OR LAW ENFORCEMENT AUTHORITIES. WE HAVE NO LIABILITY OR RESPONSIBILITY TO ANYONE FOR PERFORMANCE OR NONPERFORMANCE OF THE ACTIVITIES DESCRIBED IN THIS SECTION.
Content Standards
These content standards apply to all photographs, images, or videos of you that you gave permission to us to use, post, or disclose and content that you post to social media through our Website (“User Contributions”) you post, submit, display, or transmit on or through this Website. User Contributions must comply with all applicable federal, state, local, and international laws and regulations. Without limiting the foregoing, User Contributions must not:
Contain any material which is defamatory, obscene, indecent, abusive, offensive, harassing, violent, hateful, inflammatory, or otherwise objectionable;
Promote sexually explicit or pornographic material, violence, or discrimination based on race, sex, religion, nationality, disability, sexual orientation, or age;
Infringe any patent, trademark, trade secret, copyright, or other intellectual property or other rights of any other person;
Violate the legal rights (including the rights of publicity and privacy) of others or contain any material that could give rise to any civil or criminal liability under applicable laws or regulations or that otherwise may be in conflict with these Terms of Use, HIPAA Policy, and our Website Privacy Policy;
Be likely to deceive any person;
Promote any illegal activity, or advocate, promote, or assist any unlawful act;
Cause annoyance, inconvenience, or needless anxiety or be likely to upset, embarrass, alarm, or annoy any other person;
Impersonate any person, or misrepresent your identity or affiliation with any person or organization;
Involve commercial activities or sales, such as contests, sweepstakes, and other sales promotions, barter, or advertising; or
Give the impression that they emanate from or are endorsed by us or any other person or entity, if this is not the case.
We cannot review all material before it is posted on or through the Website and cannot ensure prompt removal of objectionable material after it has been posted. Accordingly, we assume no liability for any action or inaction regarding transmissions, communications, or content provided by any user or third party.
Copyright Infringement
If you believe that any materials on the Website violate your copyright, please contact us using the contact information on the last page of this Terms of Use. It is the policy of the Practice to terminate the user accounts of repeat infringers.
Reliance on Information Posted
The information presented on or through the Website is made available solely for general information purposes and merely accessing our Website and its resources does not create the physician/patient relationship. We do not warrant the accuracy, completeness, or usefulness of this information. You should only review information on our Website for general information purposes and not as a recommendation, diagnosis, or solution to any specific condition or treatment. Any reliance you place on such information is strictly at your own risk. We disclaim all liability and responsibility arising from any reliance placed on such materials by you or any other visitor to the Website, or by anyone who may be informed of any of its contents. This Website may include content provided by third parties, including materials provided by other users, bloggers and third-party licensors, syndicators, aggregators and/or reporting services. All statements and/or opinions expressed in these materials, and all articles and responses to questions and other content, other than the content provided by the Practice, are solely the opinions and the responsibility of the person or entity providing those materials. These materials do not necessarily reflect the opinion of the Practice. We are not responsible, or liable to you or any third party, for the content or accuracy of any materials provided by any third parties.
Changes to the Website
We may update the content on this Website from time to time, but its content is not necessarily complete or up-to-date. Any of the material on the Website may be out of date at any given time, and we are under no obligation to update such material.
Information About You and Your Visits to the Website
All information we collect on this Website is subject to our HIPAA Policy and our Website Privacy Policy. By using the Website, you consent to all actions taken by us with respect to your information in compliance with the HIPAA Policy and our Website Privacy Policy. You may link to our homepage, provided you do so in a way that is fair and legal and does not damage our reputation or take advantage of it, but you must not establish a link in such a way as to suggest any form of association, approval, or endorsement on our part without our express written consent. This Website may provide certain social media features that enable you to link from your own or certain third-party websites to certain content on this Website, send e-mails or other communications with certain content links to certain content, on this Website, or cause limited portions of content on this Website to be displayed or appear to be displayed on your own or certain third-party websites. You may use these features solely as they are provided by us, and solely with respect to the content they are displayed with and otherwise in accordance with any additional terms and conditions we provide with respect to such features. Subject to the foregoing, you must not establish a link from any website that is not owned by you, link to any part of the Website other than the homepage, or otherwise take any action with respect to the materials on this Website that is inconsistent with any other provision of these Terms of Use. The website from which you are linking, or on which you make certain content accessible, must comply in all respects with the Content Standards set out in these Terms of Use. You agree to cooperate with us in causing any unauthorized framing or linking immediately to cease. We reserve the right to withdraw linking permission without notice. We may disable all or any social media features and any links at any time without notice in our discretion.
Links from the Website; Third Party Applications
If the Website contains links to other sites and resources provided by third parties, these links are provided for your convenience only. This includes links contained in advertisements, including banner advertisements and sponsored links. We have no control over the contents of those sites or resources and accept no responsibility for them or for any loss or damage that may arise from your use of them. If you decide to access any of the third party websites linked to this Website, you do so entirely at your own risk and subject to the terms and conditions of use for such websites.
The Website may contain one or more tools or applications developed by or licensed from third party providers (“Third Party Applications”), one of which may include a web-portal healthcare access system, as well as patient-portals accessible through our electronic medical record (the “Patient Portal”). We shall not be responsible for the performance or your use of the Third Party Applications, each of which are provided without warranty of any kind by us. If we utilize a Patient Portal that allows participants to send messages regarding their healthcare by electronic inquiry to healthcare staff members, then the following terms shall apply:
Not for Emergencies: We and our affiliates caution you that use of the Patient Portal is not intended for emergency situations requiring immediate attention.
Getting a Response: We and our affiliates will make their best efforts to provide timely responses to electronic inquiries, but response times are not guaranteed.
If our clinical staff not be immediately available, it may take several business days for a response.
The electronic system is never appropriate for emergencies. We cannot respond to emergencies using this system. 911 and other phone-based emergency response systems have been set up to deal with emergencies.
Responses depend on communications that include sufficient information to make a recommendation. Photographs may be uploaded and other data included. You are responsible for providing sufficient information to receive a response. If insufficient information is provided, our staff may respond by requesting more information, or by stating that they cannot provide an answer to the inquiry without more information.
Where our staff think it is appropriate, the response may (but is not required to) include contacting you by regular mail, phone, or other means than electronic response. By using the Patient Portal, you agree to allowing us to contact you in this manner.
Your medical record may be supplemented by information you upload (or communications you make) through the Patient Portal.
In addition, we may employ features on our Website that automatically gathers and posts positive reviews about our Practice. If you post positive reviews about our Practice or physician (even if posted to a Third Party Application, or through a third party search engine, review service, or other website), you consent and agree that we may post, automatically gather, and use such review for any purpose permitted by law and in connection with such authorization, hereby assign your intellectual property rights in and to the same to us.
Geographic Restrictions
The owner of the Website is based in the State of Alabama in the United States. We provide this Website for use only by persons located in the United States. We make no claim that the Website or any of its content is accessible or appropriate outside of the United States. Access to the Website may not be legal by certain persons or in certain countries. If you access the Website from outside the United States, you do so on your own initiative and are responsible for compliance with local laws.
Disclaimer of Warranties
You understand that we cannot and do not guarantee or warrant that files available for downloading from the internet or that the Website or Third Party Applications will be free of viruses or other destructive code. You are responsible for implementing sufficient procedures and checkpoints to satisfy your particular requirements for anti-virus protection and accuracy of data input and output, and for maintaining a means external to our site for any reconstruction of any lost data.
WE WILL NOT BE LIABLE FOR ANY LOSS OR DAMAGE CAUSED BY A DISTRIBUTED DENIAL-OF-SERVICE ATTACK, VIRUSES OR OTHER TECHNOLOGICALLY HARMFUL MATERIAL THAT MAY INFECT YOUR COMPUTER EQUIPMENT, COMPUTER PROGRAMS, DATA, OR OTHER PROPRIETARY MATERIAL DUE TO YOUR USE OF THE WEBSITE, THIRD PARTY APPLICATIONS, OR ANY SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE OR TO YOUR DOWNLOADING OF ANY MATERIAL POSTED ON IT, OR ON ANY WEBSITE LINKED TO IT. YOUR USE OF THE WEBSITE, ITS CONTENT, AND ANY THIRD PARTY APPLICATIONS, SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE IS AT YOUR OWN RISK. THE WEBSITE, ITS CONTENT, AND ANY THIRD PARTY APPLICATIONS, SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS, WITHOUT ANY WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED. NEITHER THE PRACTICE NOR ANY PERSON ASSOCIATED WITH THE PRACTICE MAKES ANY WARRANTY OR REPRESENTATION WITH RESPECT TO THE COMPLETENESS, SECURITY, RELIABILITY, QUALITY, ACCURACY, OR AVAILABILITY OF THE WEBSITE OR THIRD PARTY APPLICATIONS. WITHOUT LIMITING THE FOREGOING, NEITHER THE PRACTICE NOR ANYONE ASSOCIATED WITH THE PRACTICE REPRESENTS OR WARRANTS THAT THE WEBSITE, ITS CONTENT, OR ANY THIRD PARTY APPLICATIONS, SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE WILL BE ACCURATE, RELIABLE, ERROR-FREE, OR UNINTERRUPTED, THAT DEFECTS WILL BE CORRECTED, THAT OUR SITE OR THE SERVER THAT MAKES IT AVAILABLE ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS, OR THAT THE WEBSITE, THIRD PARTY APPLICATIONS, OR ANY SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE WILL OTHERWISE MEET YOUR NEEDS OR EXPECTATIONS. THE PRACTICE HEREBY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO ANY WARRANTIES OF MERCHANTABILITY, NON-INFRINGEMENT AND FITNESS FOR PARTICULAR PURPOSE. THE FOREGOING DOES NOT AFFECT ANY WARRANTIES WHICH CANNOT BE EXCLUDED OR LIMITED UNDER APPLICABLE LAW.
Limitation on Liability
IN NO EVENT WILL THE PRACTICE, ITS AFFILIATES OR THEIR LICENSORS, SERVICE PROVIDERS, EMPLOYEES, AGENTS, OFFICERS, OR DIRECTORS BE LIABLE FOR DAMAGES OF ANY KIND, UNDER ANY LEGAL THEORY, ARISING OUT OF OR IN CONNECTION WITH YOUR USE, OR INABILITY TO USE, THE WEBSITE, ANY WEBSITES LINKED TO IT, ANY CONTENT ON THE WEBSITE OR SUCH OTHER WEBSITES (INCLUDING ANY PHOTOGRAPHS, IMAGES, OR VIDEOS OF YOU THAT YOU GAVE PERMISSION TO US TO USE, POST, OR DISCLOSE) OR ANY THIRD PARTY APPLICATIONS, SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE OR SUCH OTHER WEBSITES (NOT INCLUDING THE DELIVERY OF HEALTHCARE SERVICES TO YOU), INCLUDING ANY DIRECT, INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO, PERSONAL INJURY, PAIN AND SUFFERING, EMOTIONAL DISTRESS, LOSS OF REVENUE, LOSS OF PROFITS, LOSS OF BUSINESS OR ANTICIPATED SAVINGS, LOSS OF USE, LOSS OF GOODWILL, LOSS OF DATA, AND WHETHER CAUSED BY TORT (INCLUDING NEGLIGENCE), BREACH OF CONTRACT, OR OTHERWISE, EVEN IF FORESEEABLE. THE FOREGOING DOES NOT AFFECT ANY LIABILITY WHICH CANNOT BE EXCLUDED OR LIMITED UNDER APPLICABLE LAW.
Indemnification
You agree to defend, indemnify and hold harmless the Practice, its affiliates, licensors and service providers, and its and their respective officers, directors, employees, contractors, agents, licensors, suppliers, successors, and assigns from and against any claims, liabilities, damages, judgments, awards, losses, costs, expenses, or fees (including reasonable attorneys’ fees) arising out of or relating to your violation of these Terms of Use or your use of the Website, its Content, or the Third Party Applications including, but not limited to, your User Contributions (including any photographs, images, or videos of you that you gave permission to us to use, post, or disclose on the Website or through Third Party Applications), any use of the Website’s content, services, and products other than as expressly authorized in these Terms of Use or your use of any information obtained from the Website.
Governing Law and Jurisdiction
All matters relating to the Website and these Terms of Use and any dispute or claim arising therefrom or related thereto (in each case, including non-contractual disputes or claims), shall be governed by and construed in accordance with the internal laws of the State of Alabama without giving effect to any choice or conflict of law provision or rule (whether of the State of Alabama or any other jurisdiction). Any legal suit, action, or proceeding arising out of, or related to, these Terms of Use or the Website shall be instituted exclusively the courts of the State of Alabama in each case located in the County of Lauderdale or in the federal courts of the Northern District of Alabama, although we retain the right to bring any suit, action, or proceeding against you for breach of these Terms of Use in your country of residence or any other relevant country. You waive any and all objections to the exercise of jurisdiction over you by such courts and to venue in such courts.
Limitation on Time to File Claims
TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, ANY CAUSE OF ACTION OR CLAIM YOU MAY HAVE ARISING OUT OF OR RELATING TO THESE TERMS OF USE OR THE WEBSITE OR THIRD PARTY APPLICATIONS MUST BE COMMENCED WITHIN ONE (1) YEAR AFTER THE CAUSE OF ACTION ACCRUES, OTHERWISE, SUCH CAUSE OF ACTION OR CLAIM IS PERMANENTLY BARRED.
Waiver and Severability
No waiver of by the Practice of any term or condition set forth in these Terms of Use shall be deemed a further or continuing waiver of such term or condition or a waiver of any other term or condition, and any failure of the Practice to assert a right or provision under these Terms of Use shall not constitute a waiver of such right or provision. If any provision of these Terms of Use is held by a court or other tribunal of competent jurisdiction to be invalid, illegal, or unenforceable for any reason, such provision shall be eliminated or limited to the minimum extent such that the remaining provisions of the Terms of Use will continue in full force and effect.
Entire Agreement
The Terms of Use, our HIPAA Policy, and Website Privacy Policy constitute the sole and entire agreement between you and the Practice with respect to the Website and supersede all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to the Website. In the event that there is any inconsistency between statements in these Terms of Use and the HIPAA Policy or between statements in the Website Privacy Policy and the HIPAA Policy, then the statements in the HIPAA Policy will control.
Your Comments and Concerns
This website is operated by ENT Center of Northwest Alabama LLC, an Alabama limited liability Practice. All notices, feedback, comments, requests for technical support, and other communications relating to the Website should be directed to ENT Center of Northwest Alabama LLC at: contact@entcenteralabama.com. Thank you for visiting the Website.
Revised: July 21, 2021
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ENT Center of Northwest Alabama LLC, an Alabama limited liability company (“Practice”, “we”, “us”, or “our”) respects your privacy and are committed to protecting it through our compliance with this policy (the “Website Privacy Policy”). This Website Privacy Policy describes the types of information we may collect from you or that you may provide when you visit the website www.mcosmeticsurgery.com (our “Website”) and our practices for collecting, using, maintaining, protecting, and disclosing that information. This policy is, at all times, subject to our HIPAA Policy located at www.entcenteralabama.com/privacy (“HIPAA Policy”) with respect to information covered by the Health Insurance Portability and Accountability Act (“HIPAA”).
This Website Privacy Policy applies to information we collect:
On this Website In email, text, and other electronic messages between you and this Website.
When you interact with our advertising and applications on third-party websites and services, but only if those applications or advertising include links to this policy.
It does not apply to information collected by us offline or through any other means, including on any other website operated by Practice or any third party (including our affiliates and subsidiaries) or by any third party (including our affiliates and subsidiaries), including through any application or content (including advertising) that may link to or be accessible from or on the Website. Occasionally, you may be asked to utilize web applications or programs in connection with the Practice (such as a “patient portal” or payment applications as well as certain video streaming services) (the “Third Party Applications”). Your use of these Third Party Applications may be subject to the terms and conditions and privacy policies of the respective providers of the Third Party Applications and you agree to use the Third Party Applications in accordance such privacy policies. These third party providers, and not the Practice, shall be responsible for the Third Party Applications and your use thereof.
ADDITONALLY, ANY INFORMATION COVERED BY HIPAA IS GOVERNED BY OUR HIPAA POLICY AND WILL ONLY BE USED AND/OR DISCLOSED IN A MANNER FULLY COMPLIANT WITH HIPAA. ANY STATEMENTS IN THIS WEBSITE PRIVACY POLICY INCONSISTENT WITH OUR HIPAA POLICY ARE SUPERSEDED AND CONTROLLED BY OUR HIPAA POLICY WITH RESPECT TO HIPAA-GOVERNED INFORMATION.
Please read this policy carefully to understand our policies and practices regarding your information and how we will treat it. If you do not agree with our policies and practices, you may not use our Website. By accessing or using this Website, you agree to this Website Privacy Policy, our Website’s terms of use located at www.entcenteralabama.com/terms (“Website Terms of Use”), and our HIPAA Policy. This policy may change from time to time. Your use of this Website after we make changes is deemed to be acceptance of those changes, so please check the policy periodically for updates.
Children Under the Age of 13
Our Website is not intended for children under 13 years of age. No one under age 13 may provide any personal information to or on the Website. We do not knowingly collect personal information from children under 13. If you are under 13, do not use or provide any information on this Website or on or through any of its features, register on the Website, make any purchases through the Website, use any of the interactive or public comment features of this Website, or provide any information about yourself to us, including your name, address, telephone number, email address, or any screen name or username you may use. If we learn we have collected or received personal information from a child under 13 without verification of parental consent, we will delete that information. If you believe we might have any information from or about a child under 13, please contact the us using the contact information on the last page of this Website Privacy Policy.
Information We Collect About You and How We Collect It
We collect several types of information from and about users of our Website, including information: by which you may be personally identified, such as name, postal address, e-mail address, telephone number, or any other information the Website collects that is defined as personal or personally identifiable information under an applicable law (“Personal Information”);
that is about you but individually does not identify you, such as information you provide to us about your accomplishments or activities; and
about your internet connection, the equipment you use to access our Website and usage details.
We collect this information either directly from you when you provide it to us, automatically as you navigate through the site, or from third parties such as our business partners. Information collected automatically may include usage details, IP addresses, and information collected through cookies, web beacons, and other tracking technologies.
Information You Provide to Us
The information we collect on or through our Website includes any information that you provide by completing forms on our Website. This includes:
Information provided at the time of registering to use our Website, subscribing to our services, posting material, or requesting further services;
Any information provided if you report a problem with our Website;
Records and copies of your correspondence (including email addresses),if you contact us;
Your responses to surveys or questionnaires;
Details of transactions you carry out through our Website and of the fulfillment of your orders.
Financial information collected used to process your order through our Website.
Your search queries on the Website
You also may provide information to be published or displayed on public areas of the Website, or transmitted to other users of the Website or third parties (collectively, “User Contributions”). Your User Contributions published on the Website and transmitted to others at your own risk. Please be aware that no security measures are perfect. Additionally, we cannot control the actions of other users of the Website with whom you may choose to share your User Contributions. Therefore, despite taking all reasonable security precautions that we take to safeguard User Contributions on the Website, we cannot and do not guarantee that your User Contributions will not be viewed by unauthorized persons.
Information We Collect Through Automatic Data Collection Technologies
As you navigate through and interact with our Website, we may use automatic data collection technologies to collect certain information about your equipment, browsing actions, and patterns, including:
Details of your visits to our Website, including traffic data, location data, logs, and other communication data and the resources that you access and use on the Website; and
Information about your computer and internet connection, including your IP address, operating system, and browser type.
The information we collect automatically is statistical data and does not include personal information, but we may maintain it or associate it with personal information we collect in other ways or receive from third parties. This helps us to improve our Website and to deliver a better and more personalized service to you. Doing so also allows us to estimate our audience size and usage patterns, to speed up searches conducted on the Website, and to recognize returning customers. We also store information about your preferences which allows us to customize our Website according to your individual interests. The technologies we use for this automatic data collection may include cookies (or browser cookies). A cookie is a small file placed on the hard drive of your computer. You may refuse to accept browser cookies by activating the appropriate setting on your browser. However, if you select this setting you may be unable to access certain parts of our Website. Unless you have adjusted your browser setting so that it will refuse cookies, our system will issue cookies when you direct your browser to our Website. For more information about managing your privacy and security settings for cookies, see www.aboutcookies.org. We do not collect personal information automatically, but we may tie this information to personal information about you that we collect from other sources or you provide to us.
How We Use Your Information
We use information that we collect about you or that you provide to us, including any personal information
to present our Website and its contents to you;
to provide you with information, products, or services that you request from us; and
to fulfill any other purpose for which you provide it;
to provide you with notices about your account or subscription, including expiration and renewal notices;
to carry out our obligations and enforce our rights arising from any contracts entered into between you and us, including for billing and collection;
to notify you about changes to our Website or any products or services we offer or provide though it;
to allow you to participate in interactive features on our Website;
in any other way we may describe when you provide the information; and
for any other purpose with your consent and consistent with applicable law.
Disclosure of Your Information
We reserve the right to disclose aggregated information about our users, and information that does not identify any individual (including de-identified information), without restriction. We reserve the right to disclose personal information that we collect or you provide as described in this privacy policy to:
our subsidiaries and affiliates;
to contractors, service providers, and other third parties we use to support our business;
to a buyer or other successor in the event of a merger, divestiture, restructuring, reorganization, dissolution, or other sale or transfer of some or all of the Practice’s assets, whether as a going concern or as part of bankruptcy, liquidation, or similar proceeding, in which personal information held by the Practice about our Website users is among the assets transferred;
to fulfill the purpose for which you provide it;
for any other purpose disclosed by us when you provide the information with your consent.
We may also disclose your personal information:
to comply with any court order, law, or legal process, including to respond to any government or regulatory request;
to enforce or apply our Website Terms of Use and other agreements, including for billing and collection purposes;
if we believe disclosure is necessary or appropriate to protect the rights, property, or safety of the Practice, our customers, or others
This may include exchanging information with other companies and organizations for the purposes of fraud protection and credit risk reduction.
Third Party Platforms
Our website
Choices About How We Use and Disclose Your Information
We strive to provide you with choices regarding the personal information you provide to us. You can configure your browser to refuse all or some browser cookies, or to alert you when cookies are being sent. If you disable or refuse cookies, please note that some parts of this site may then be inaccessible or not function properly.
Promotional Offers from the Practice
If you do not wish to have your email address used by the Practice to promote our own or third parties’ products or services, you can opt-out by sending us an email stating your request using the contact information on the last page of this Website Privacy Policy. If we have sent you a promotional email, you may send us a return email asking to be omitted from future email distributions. This opt out does not apply to information provided to the Practice as a result of a product purchase, warranty registration, product service experience or other transactions. Targeted Advertising. If you do not want us to use information that we collect or that you provide to us to deliver advertisements according to our advertisers’ target-audience preferences, you can opt-out by sending us an email stating your request using the contact information on the last page of this Website Privacy Policy. We do not control third parties’ collection or use of your information to serve interest-based advertising. However, these third parties may provide you with ways to choose not to have your information collected or used in this way. You can opt out of receiving targeted ads from members of the Network Advertising Initiative (“NAI”) on the NAI’s website. Accessing and Correcting Your Information. If you delete your User Contributions from the Website, copies of your User Contributions may remain viewable in cached and archived pages or might have been copied or stored by other Website users. Proper access and use of information provided on the Website, including User Contributions, is governed by our Website Terms of Use.
Your California Privacy Rights
California Civil Code Section § 1798.83 permits users of our Website that are California residents to request certain information regarding our disclosure of personal information to third parties for their direct marketing purposes. To make such a request, please send an email using the contact information at the end of this Website Privacy Policy. Data Security. The safety and security of your information also depends on you. Where we have given you (or where you have chosen) a password for access to certain parts of our Website, you are responsible for keeping this password confidential. We ask you not to share your password with anyone. Unfortunately, the transmission of information via the internet is not completely secure. Although we do our best to protect your personal information, we cannot guarantee the security of your personal information transmitted to our Website. Any transmission of personal information is at your own risk. We are not responsible for circumvention of any privacy settings or security measures contained on the Website.
Changes to Our Privacy Policy
It is our policy to post any changes we make to our privacy policy on this page. If we make material changes to how we treat our users’ personal information, we will notify you by email to the email address specified in your account or through a notice on the Website home page. The date the privacy policy was last revised is identified at the top of the page. You are responsible for ensuring we have an up-to-date active and deliverable email address for you, and for periodically visiting our Website and this privacy policy to check for any changes.
Contact Information
To ask questions or comment about this privacy policy and our privacy practices, contact us at: contact@entcenteralabama.com.
Revised: July 21, 2021
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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Privacy Notice is being provided to you by ENT Center of Northwest Alabama LLC and their medical staff (“we”, “us”, or “our”), as a requirement of a federal law, the Health Insurance Portability and Accountability Act (HIPAA). This Privacy Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law and applies to all of our facilities, services, and persons that provide health care to you. It also describes your rights to access and control your protected health information in some cases. Your “protected health information” means any written and oral health information about you, including information that is created or received by your health care provider, and that relates to your past, present or future physical or mental health or condition. If you received this notice electronically, you are entitled to a paper copy of this Privacy Notice. If you received a copy of this notice in paper form, you can find it electronically at www.entcenteralabama.com/privacy.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
We may use your protected health information for purposes of providing treatment, obtaining payment for treatment, and conducting health care operations. Your protected health information may be used or disclosed only for these purposes unless we have obtained your authorization or the use or disclosure is otherwise permitted by the HIPPA privacy regulations or state law. Disclosures of your protected health Information for the purposes described in this Privacy Notice may be made in writing, orally, or by facsimile.
A. TREATMENT.
We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes coordination or management of your health care with a third party for treatment purposes. For example, we may disclose your protected health information to a laboratory, pharmacy or other treating physicians.
B. PAYMENT.
Your protected health information will be used, as needed, to obtain payment for the services that we provide. This may include certain communications to your health insurance company to get approval for the procedure that we have scheduled (i.e. pre-authorization or prior approval). We may also disclose protected health information to your health insurance company to determine your eligibility for benefits or whether a particular service is covered under your plan or to demonstrate medical necessity of the services or as required by your insurance company, for utilization review. We may also disclose protected health information to another provider involved in your case for the other provider’s payment activities. This may include disclosure of demographic information to anesthesia care providers.
C. OPERATIONS.
We may use or disclose your protected health information as necessary for our own health care operation, to facilitate the function of our surgical facilities, and to provide quality care to all patients. Health care operations include such activities as: quality assessment and administration improvement activities, employee review activities, post-operative patient assessments, training programs, including those in which students, trainees, or practitioners in health care learn under supervision, accreditation, certification, licensure, or credentialing activities, review and auditing, including compliance review, medical reviews, legal services and maintaining compliance programs, and business management and general administrative activities.
D. OTHER USES AND DISCLOSURES.
As a part of your treatment, payments, and health care operations, we may also use or disclose your protected health information for the following purposes: to remind you of your surgery date, provide pre-operative instructions, and discuss financial arrangements.
USES AND DISCLOSURES BEYOND TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS PERMITTED WITHOUT AUTHORIZATION OR OPPORTUNITY TO OBJECT
Federal privacy rules allow us to use or disclose your protected health information without your permission or authorization for a number of reasons including the following:
A. WHEN LEGALLY REQUIRED.
We will disclose your protected health information when we are required to do so by any federal, state, or local law. For example, we may disclose medical information to federal, state, and local law enforcement officials; in response to a judicial order, subpoena, or other lawful process; and to address matters of public interest as required or permitted by law. For example, we are required to disclose medical information about you to the Secretary of the U.S. Department of Health and Human Services if the Secretary is investigating or determining compliance with HIPAA.
B. WHEN THERE ARE RISKS TO PUBLIC HEALTH.
We may disclose your protected health information for the following public activities and purposes: To prevent, control, or report disease, injury or disability as permitted by law. To report vital events such as birth or death as permitted by or required by law. To conduct public health surveillance, investigations and interventions as permitted or required by law. To collect or report adverse events and product defects, track FDA regulated products, enable product recalls, repairs or replacements to the FDA and to conduct post marketing surveillance. To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease as authorized by law. To report to an employer information about an individual who is a member of the workforce as legally permitted or required.
C. TO REPORT SUSPECTED ABUSE, NEGLECT, OR DOMESTIC VIOLENCE.
We may notify government authorities if we believe that a patient is the victim of abuse, neglect or domestic violence when specifically required or authorized by law or when the patient agrees to the disclosure.
D. TO CONDUCT HEALTH OVERSIGHT ACTIVITIES.
We may disclose your protected health information to a health oversight agency for activities including audits; civil, administrative, or criminal investigations, proceedings, or actions; inspections; licensure or disciplinary actions; or other activities necessary for appropriate oversight as authorized by law. We will not disclose your health information under this authority if you are the subject of an investigation and your health information is not directly related to your receipt of healthcare or public benefits.
E. IN CONNECTION WITH JUDICIAL AND ADMINISTRATIVE PROCEEDINGS.
We may disclose your protected health information to a health oversight agency for activities including audits; civil, administrative, or criminal investigations, proceedings, or actions; inspections; licensure or disciplinary actions; or other activities necessary for appropriate oversight as authorized by law. We will not disclose your health information under this authority if you are the subject of an investigation and your health information is not directly related to your receipt of healthcare or public benefits.
F. FOR LAW ENFORCEMENT PURPOSES.
We may disclose your health information to a law enforcement official for law enforcement purposes as follows: As required by law for reporting of certain types of wounds or other physical injuries; Pursuant to court order, court-ordered warrant, subpoena, summons or similar process; For the purpose of identifying or locating a suspect, fugitive, material witness or missing person; Under certain limited circumstances, when you are the victim of a crime; To a law enforcement official if we suspect that your health was the result of a crime; and In an emergency to report a crime.
G. TO CORONER, FUNERAL DIRECTORS, AND ORGAN DONATION.
We may disclose health information to a coroner or medical examiner for identification purposes, to determine cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties.
H. FOR RESEARCH PURPOSES.
We may use or disclose your health information for research when the use or disclosure for research has been approved by an institutional review board that has reviewed the research proposal and research protocols to address the privacy of your protected health information.
I. IN THE EVENT OF A SERIOUS THREAT TO HEALTH OR SAFETY.
We may, consistent with applicable law and ethical standards of conduct, use or disclose your health information if we believe, in good faith that such use or disclosure is necessary to prevent or lessen a serious and imminent threat to your health and safety or to the health and safety of the public.
J. FOR SPECIFIED GOVERNMENT FUNCTIONS.
In certain circumstances, federal regulations authorize us to use or disclose your health information to facilitate specified government functions relating to military and veterans activities, national security and intelligence activities, protective services for the President and others, medical suitability determinations, correctional institutions, and law enforcement custodial situations.
K. FOR WORKER’S COMPENSATION.
We may release your health information to comply with worker’s compensation laws or similar programs.
L. TO BUSINESS ASSOCIATES.
We may disclose your health information to our business associates (as defined under HIPAA) provided we enter into contracts with these persons requiring them to only use and disclose your health information as we are permitted to do so under HIPAA. Uses and Disclosure Permitted without Authorization but with Opportunity to Object. We may disclose your health information to your family member or a close family friend if it is directly relevant to the person’s involvement in your surgery or payment related to your surgery. We can also disclose your information in connection with trying to locate or notify family members or others involved in your care concerning your location, condition or death. You may object to these disclosures. If you do not object to these disclosures or we can infer from the circumstances that you do not object or we determine, in the exercise of our professional judgment, that it is in your best interests for us to make disclosure of information that is directly relevant to the person’s involvement with your care, we may disclose your health information. Uses and Disclosures which you Authorize. Other than as stated above, we will not disclose your health information other than with your written authorization. You may revoke your authorization in writing at any time except to the extent that we have acted in reliance upon the authorization.
YOUR RIGHTS
You have the following rights regarding your health information:
A. THE RIGHT TO INSPECT AND COPY YOUR HEALTH INFORMATION.
You may inspect and obtain a copy of your health information that is contained in a designated record set for as long as we maintain the health information. A “designated record set” contains medical and billing records and any other records that your surgeon and we use for making decisions about you. Under the federal law, however, you may not inspect or copy health information that is subject to a law that prohibits access to health information or that allows us to withhold disclosure. Depending on the circumstances, you may have the right to have a decision to deny access reviewed. We may deny your request to inspect or copy your health information, if in our professional judgment, we determine that the access requested is likely to endanger your life or safety or that of another person, or that it is likely to cause substantial harm to another person referenced with the information. You have the right to request a review of this decision. To inspect and copy your medical information, you submit a written request to the Privacy Officer whose contact information is listed on the last page of this Privacy Notice. If you request a copy of your information, we may charge you a fee for the costs of copying, mailing or other costs incurred by us in complying with your request. These costs will be made known to you at the time of your request.
B. THE RIGHT TO REQUEST A RESTRICTION ON USES AND DISCLOSURES OF YOUR HEALTH INFORMATION.
You may ask us not to use or disclose certain parts of your health information for the purposes of treatment, payment or health care operations. You may also request that we do not disclose your health information to family members or friends who may be involved in your care or for notification purposes as described in this Privacy Notice. Your request must state the specific restriction requested and to whom you want the restriction to apply. We are not required to agree to a restriction that you may request. We will notify you if we deny your request to a restriction. If we do agree to the requested restriction, we will not use or disclose your health information in violation of that restriction unless it is needed to provide emergency treatment. Under certain circumstance, we may terminate our agreement to a restriction.
C. THE RIGHT TO REQUEST TO RECEIVE CONFIDENTIAL COMMUNICATIONS FROM US BY ALTERNATIVE MEANS OR AT AN ALTERNATIVE LOCATION.
You may have the right to request that we communicate with you in certain ways. We will accommodate reasonable requests. We may condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not require you to provide an explanation for your request.
D. THE RIGHT TO REQUEST AMENDMENTS TO YOUR HEALTH INFORMATION.
You may request an amendment of health information about you in a designated record set for you as long as we maintain this information. In certain cases, we may deny your request. If we deny your request, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Requests for amendment must be in writing and must be directed to our Privacy Officer. In this written request, you must also provide a reason to support the requested amendments.
E. THE RIGHT TO RECEIVE AN ACCOUNTING.
You may have the right to request an accounting of certain disclosures of your health information made by us. This right applies to disclosure for purposes other than treatment, payment or health care operations as described in the Privacy Notice. We are also not required to account for disclosures that you requested, disclosures that you agreed to by signing and authorization form disclosures for our directory, to friends or family members involved in your care, or certain other disclosures we are permitted to make without your authorization. The request must be made in writing to our Privacy Officer. The request should specify the time period sought for the accounting. We are not required to provide an accounting for disclosures that take place prior to April 14, 2003. Accounting requests may not be made for periods of time in excess of six years. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
F. THE RIGHT TO OBTAIN A COPY OF THIS NOTICE.
Upon request, we will provide a separate paper copy of this notice even if you have already received a copy of this notice.
OUR DUTIES.
We are required by law to maintain the privacy of your health information and to provide you with this Privacy Notice of our duties and privacy practices. We are required to abide by terms of this Notice as may be amended from time to time. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all future health information that we maintain. If we change our Notice, we will provide a copy of the revised Notice by sending a copy of the revised Notice via regular mail or through in-person contact.
COMPLAINTS.
You have the right to lodge complaints to us and to the Secretary of Health and Human Services if you believe that your privacy rights have been violated. You may complain to us by contacting the Privacy Officer verbally or in writing, using the information below. We encourage you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint. Our contact person for all issues regarding patient privacy and your rights under the federal privacy standards is the Privacy Officer. Information regarding matters covered by this Notice can be requested by contacting the Privacy Officer. If you feel that your privacy rights have been violated by us, you may submit a complaint to our Privacy Officer at: ENT Center of Northwest Alabama LLC, 1949 Florence Boulevard, Florence, Alabama 35630, ATTN: Privacy Officer. The Privacy Officer can be contacted by telephone at 256-415-8100. To file a complaint with the Secretary of the Department of Health and Human service, contact: The U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201, or call at: 202-619-0257 or at the toll free number 877-696-6775, or email at: hhs.mail@hhs.gov.
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Starting January 1, 2022, the No Surprises Act will protect certain patients from surprise bills for emergency services at nonparticipating facilities, services provided by nonparticipating providers at participating facilities, and air ambulance services from nonparticipating providers. The No Surprises Act also enables uninsured or self-pay patients to receive a good faith estimate of the cost of scheduled care ahead of time.
Balance Billing Disclosure
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing if you are enrolled in a group health plan, group or individual health insurance coverage, or a Federal Employees Health Benefits Plan. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.
You’re protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have these protections:
You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
Generally, your health plan must:
If you think you’ve been wrongly billed, you may file a complaint with the federal government at www.cms.gov/nosurprises/consumers or call 1-800-985-3059. Visit www.cms.gov/nosurprises for more information about your rights under federal law.
Good Faith Estimate Disclosure
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, health care providers need to give patients who don’t have certain types of health care coverage or are not using certain types of health care coverage an estimate of the bill for medical items and services before those items or services are provided.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask your health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate and the bill.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
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FIRST OFFICE VISIT | $100, $125, $150
FOLLOW UP | $50, $75, $100
CT | $100
FLEX SCOPE | $120
NASAL SCOPE | $150
INPATIENT INITIAL | $150
INPATIENT FOLLOW UP | $75
STEROID EAR SHOT | $210
MAXED OUT MEDICAID 1ST VISIT | $100, $125, $150
MAXED OUT MEDICAID FOLLOW UP | $50, $75, $100
ALLERGY TEST | $635
ALLERGY MIXING 1 VIAL | $1,000
ALLERGY MIXING 2 VIALS | $1,250
ALLERGY MIXING 3 VIALS | $1,500
ALLERGY SHOT PER VISIT | $12
ALLERGY DROPS (LAST 2 MONTHS) | $215
IN OFFICE BALLOON | (PRICE VARIES DUE TO NEED OF SERVICES)$3,500-$5,000
HEARING TEST: 92557 | $40
HEARING TEST: 92567 | $15
NOSEBLEED CONTROL | $125, $225
EAR LOBE REPAIR | $250
EACHLATERA | $2,000
CERUMEN | $45
TUBES/EAR INCISION | $165 PER EAR