Insurance & Billing Information

Helping You Navigate Insurance and Billing

Thank you for choosing Denver Sinus Care for your ENT and skull base specialty care. We are committed to providing excellent care while helping you better understand the insurance and billing process.


Because insurance coverage can be complex and varies widely between plans, we encourage all patients to review their benefits carefully before receiving care.

Insurance Coverage

Denver Sinus Care participates with several commercial insurance plans in Colorado. However, coverage varies by insurance company and by individual plan. Even if we are in network with your insurance company, your specific plan may have different:

  • Provider networks
  • Referral requirements
  • Authorization rules
  • Benefit limitations
  • Out-of-network policies



Your insurance policy is a contract between you (and/or your employer) and your insurance carrier. Coverage decisions are determined by your insurance plan, including what services are covered and what portion of the cost is your responsibility.

Patient responsibility may include:

  • Co-pays
  • Co-insurance
  • Deductibles
  • Non-covered services


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What We Ask Patients to Verify

Before your appointment or procedure, we strongly encourage you to contact your insurance company and/or employer to confirm:

  • Whether our providers are in network with your specific plan
  • Whether out-of-network benefits are available
  • Whether your plan allows care outside your home state, if applicable
  • Your co-pay, deductible, and co-insurance responsibilities
  • Whether a referral is required (especially for HMO plans)
  • Whether prior authorization is required for services or procedures


If your plan does not provide coverage for care in our office, please contact us so we can discuss available self-pay options.


Claims Submission & Insurance Processing

As a courtesy, we submit claims for covered services and may appeal denials when appropriate and allowed by your plan. However, all coverage and payment decisions are ultimately made by your insurance company.

Please note:

  • Patients who live outside Colorado, or who have insurance plans issued in another state, may have claims processed as out of network.
  • In many cases, we cannot determine exactly how a claim will process until it has been reviewed by the insurance carrier.
  • Insurance companies may deny services as not medically necessary, experimental, investigational, or non-covered, even when you and your physician determine a treatment is appropriate.

Payments & Balances

We collect estimated co-pays, co-insurance, deductibles, and outstanding balances at or before the time of service when applicable. These amounts are estimates based on the information available at that time.


For out-of-network plans, we may collect a self-pay fee prior to your appointment.



After your insurance company processes the claim, you may receive:

  • A statement for any remaining balance due, or
  • A refund if your account shows a credit balance


Please understand that insurance processing and appeals can take several weeks — and occasionally several months. Once claims are finalized, any amount not covered by insurance becomes the patient’s responsibility. Credit balances will be refunded promptly.

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Specialty Care & Follow-Up

Denver Sinus Care is a highly specialized ENT and skull base practice. Insurance guidelines may limit how many concerns can be addressed during a single visit, which may require additional appointments to fully evaluate and treat multiple issues.


In some situations, patients may also be referred back to their primary care provider for routine follow-up care, medication refills, or concerns that insurance does not consider specialty care.

Our Commitment to You

We are committed to providing compassionate, specialized care while helping patients better understand the insurance and billing process. We appreciate your partnership in reviewing your benefits, understanding your financial responsibilities, and communicating with us about any questions or concerns throughout your care.