Privacy Policy

Patient Registration Form

WNY ENT Financial Policy

Auth Release Form(from other provider to WNYENT)

Auth Release Form(from WNYENT to another)


Payment is required at the time services are rendered. Western New York Ear, Nose & Throat, PC accepts cash, personal check, Visa, MasterCard, and Discover. All co-payments, co-insurance, and balances are payable at reception desk upon check in.

Returned checks: A service charge of $15 is required for returned checks. If there is a past-due balance, any amount paid will be applied to the past due balance first.

Late payments: Patients with an outstanding balance of 120 days or more may be discharged from the practice unless payment arrangements are made and honored. These accounts will be referred to a collection agency unless prior agreements are made with our billing department.

To speak with our billing department, please call (716) 332-2383.

Appointment Time Policy: When we schedule appointments, the needs of our patients are always taken into consideration. If you are up to 15 minutes late for your scheduled appointment we may have to reschedule your appointment. We appreciate your timely arrival.

Appointment Policy: Our office requires 24 hours cancellation notice PRIOR to your scheduled appointment time. If you fail to notify our office 24 hours prior to your scheduled appointment you will be charged a $25.00 fee.  All no show appointments will be subject to a $35.00 fee. First occurrences may be waived. Please take the time to call and cancel.

Insurance Referral Policy: It is your responsibility as a patient (depending your contract with your health insurer) to obtain a referral from your insurance company or your referring physician PRIOR to your appointment. If you do not have a current or updated referral, your appointment may be cancelled until one is obtained.

Co-Pay, Co-Insurance and Deductible Policy: Co-Pays, Co-insurance and Deductibles are collected at the time of service per your insurance coverage. Many private insurance companies have a coinsurance for us to collect. In the case of a co-insurance, we are to collect. Deductibles are the patient’s responsibility per your insurance company. We a will  collect any necessary fee until your annual/calendar deductible is met.

New York State Red Flag Law, now requires us to have photo identification in our patients chart. Please bring New York State Drivers License or Photo Identification with you to your appointment.