New Patient

New Patient

New Patient Information

Thank you for choosing Crystal Canyon ENT & FPS as your health care provider. 

About Your Visit

Please bring the following items to your initial consultation:

  • All insurance cards
  • Photo ID
  • Completed new patient paperwork
  • If you are the guardian of a minor, bring all guardianship paperwork
  • List of medications you are taking
  • Copy of XRAYS, CT scans and any other applicable reports

Additional information for your office visit:

  • Please arrive 15 minutes prior to appointment time.
  • Co-payment is due at every office visit and the specific amount is indicated on your insurance card. If you have any questions regarding co-payment, we recommend contacting your insurance provider.
  • Arriving late to your appointment may result in your appointment being rescheduled.
  • We will make every effort to accommodate your scheduling needs. In return, we ask that you notify us at least one business day in advance if you need to reschedule your appointment.
Download New Patient Paperwork

Insurance Participation*

We are contracted with the following insurance providers. Some insurance companies require a referral or authorization before being seen by a specialist. Contact your insurance provider for more information.

  • Aetna
  • Ameriben
  • Asbait
  • Assurant Health
  • AZ Foundation
  • Blue Cross Blue Shield
  • Care 1st (AHCCCS)
  • Cigna
  • DES/DDD (AHCCCS)
  • GEHA
  • Gilsbar
  • Health Net
  • Humana
  • IHS Contract Health
  • IHS Purchase Referred Care (PRC)
  • Medicare
  • Medicare Railroad
  • Meritain
  • Mutual of Omaha
  • Tier 1 in-network provider with Pathfinder
  • Tall Tree Administrators
  • Tricare / Healthnet Federal Services
  • UMR
  • United Health Care

*Although we make every effort to keep insurance participation up-to-date, please contact our office prior to your appointment to confirm we are contracted with your insurance provider.

Billing Policies & Procedures

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  • Co-payment is due at the time of service. Not following this requirement could result in the termination and cancellation of medical coverage for patient.
  • It is the patient’s responsibility to make sure that his/her doctor is in network for private insurance plans.
  • It is the patient’s responsibility to make sure all hospital procedures and/or testing is pre-approved by the carrier. As a courtesy, our office will assist in obtaining pre-approval. However, pre-approval does not guarantee payment and all patients are expected to know their benefits and coverage under their specific insurance plan.
  • We accept Medicare assignments. All Medicare patients need to have a referring physician from the State of Arizona for initial consultation. Failure to do so may result in denial of payment.
  • Any deductibles, co-payments, and/or charges not paid by the carrier are the patient’s responsibility.
  • Payment for privately paying patients is due upon service(s) rendered.
  • The Billing Office files claims for all carriers with whom we participate. Payments by the insurance carriers will be made directly to our office. They will provide you with an Explanation of Benefits (EOB) of the charges, amount covered by your policy, and payments made to our office on your behalf. Your insurance may or may not allow a portion of your bill at which time the remaining balance is your responsibility. If you have a secondary plan, as a courtesy, the billing office will submit the primary payment information to the secondary carrier.
  • As a courtesy, the Billing Office also files claims to carriers with whom we do not participate. Payments by the insurance carriers may be sent directly to the patient instead of our office. It is the responsibility of the patient to remit payment to our office at the time of service in these cases. If you have a secondary plan, as a courtesy, the billing office will submit the primary payment information to the secondary carrier.
  • Some insurance companies require co-payments for allergy injections. As a courtesy to our patients, all services provided in the office or at the hospital will be billed to your insurance company. Most insurance companies require two or three months to process a claim. If we are not a contracted provider for your insurance company, you will be responsible for any charges that exceed the payments we receive from your insurance carrier. We DO NOT accept reasonable and customary payment as payment in full for those insurance companies for which we are not contracted.
  • In the event of default on payment toward account balance, collection fees, interest, court costs, and reasonable attorney’s fees will be the patient’s responsibility.
  • For your convenience we accept the following methods of payment: cash, debit, check, Visa, Discovery and Mastercard.

Schedule Appointment

This website serves as an introduction and brief overview of services offered at our facility. For more detailed answers to your questions, please schedule an appointment.

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