About Your Visit
We have prepared this information to assist you in your visit to our office. As always we will assist you in anyway possible with questions or concerns. Please let us know how we may better serve you. At the Michigan Ear Institute, we strive to see our patients in a timely fashion, but occasionally circumstances arise that may delay your appointment. We apologize in advance if your appointment is delayed and hope you understand that we do value your time.
To Better Serve You – What to Bring to an Appointment
- Keep all of your scheduled appointments. You must cancel / reschedule an appointment 48 hours prior to the appointment.
- Bring all paperwork to your appointment filled out and ready to give to our receptionist. You may complete the paperwork on our website to print and bring with you.
- Notify our front desk staff of any changes in your address, contact phone numbers, insurance or name changes prior to seeing the physicians. When these are incorrect it is more likely your bill will not be paid by your insurance company.
- You must bring a photo id and your insurance card to every visit.
- Co-payments and balances are due at time of service. There is a $15 charge for not paying your co-pay. You have agreed to this co-pay with your insurance company and we cannot bill this.
New Patient Information
As a new patient to our practice we would like to welcome you and provide you with the information needed to make registration more efficient at the time of your visit.
The forms below are designed for you to download, fill out and bring with you to your appointment. Please have these ready for the receptionist to enter into our computer. In addition to the forms please bring your picture id, insurance card and a list of medications you are taking to your visit.
Your appointment will be confirmed by our automated system that calls to inform you as a reminder of the appointment date, physician you are seeing, the office where your appointment is located and any other testing you will be scheduled for at the time of visit.
You may be asked to come 15 minutes early for the appointment to allow for entry of your personal information and insurance information into our computerized system. If you have had any testing done please bring the reports and any CD’s or x-rays with you.
- Physician New Patient Paperwork (PDF)
- Physical Therapy New Patient Paperwork (PDF)
- Telemedicine Consent Form (PDF)
- Records Consent Form (PDF)
- Records Release Form (PDF)
As an established patient we will still need you to bring a picture id and your insurance card with you to every visit. Your appointment will be confirmed by our automated system that will call you and comfirm the date, time, location and physician visit.
Your Financial Responsibility for all patients
Our office participates with many different types of insurance. We will bill your insurance for services, but ultimately you are responsible for paying for any services received in our office. You are responsible for paying the co-pay at time of service. According to the contract, we are not supposed to bill for co-pays.
Unfortunately, not all services are paid for by the insurance company. In cases where the service is not paid, you will be responsible for payment. We will bill your insurance company first and make sure that all the information sent to the insurance company is accurate and clearly describes any services that you received.
The Federal Law requires us to submit all claims to an insurance company accurately and report the exact service that is performed and why the service was performed. We are not allowed to change this information just so that the insurance company will pay the claim.
If you do not have insurance we require full payment of services at time of the visit. A payment plan may be possible. We accept Discover, Visa, and MasterCard and participate with Care Credit as a method of payment for services. Patients will receive a 30% discount if they pay in full when they see the doctor. This does not include hearing aids.
Covered or Non-Covered Services
It is always best to double check with your insurance company if you are unsure whether you need a referral, services are covered, not covered or if there is a deductible. Its best you know your insurance coverage before your appointment. You may call the number on the back of your insurance card to find out any information you are not sure of. Michigan Ear Institute may not be aware of your specific insurance coverage.
What About a Referral?
It is your responsibility to know the requirements from your insurance company on the need for a referral or authorization at time of visit. Because we are specialists this is very important for your care. We may not be able to see you if we do not have the proper referral or authorization. Many insurances, including HMOs require a referral to a specialist prior to the visit.
Referrals are obtained from your Primary Care Physician. Please give them 10 days notice of your need for a referral except when it is an emergency. The paperwork may be faxed to our office for the visit. Verify prior to your visit if you have a question about our receiving the referral.
Your referral should authorize any services that may be performed by the physician at MEI as well as any testing that may be necessary or indicated, such as a hearing test.
If we do not have your referral, you may be financially responsible for the cost of the visit and will be required to pay for the services in full until the referral is obtained.
For our patient’s needs, we do take Nurse Calls and prescription refills on a daily basis. These calls will be answered as quickly as possible and will be screened for emergency. True emergency calls should be made to 911 or you should go to the nearest Emergency Room for service.
We take calls for prescription refills from your pharmacy. Please have your pharmacy contact us for the appropriate medication refill request via voicemail or fax at (248) 865-6161.