Sierra Nevada Ear, Nose & Throat accepts most insurances for our patients. However, if you are a first time patient with us, or a returning patient with a new insurance provider, we encourage you to contact our office before scheduling your appointment. It is our number one priority to provide our patients with quality and responsible care.
Accepted Insurance Providers and Plans
- Aetna
- Anthem Blue Cross & Blue Shield
- Cigna
- First Health
- GEHA
- Hometown Health
- Healthcomp
- Indian Health Services
- Medicare
- Medicaid
- Multiplan
- Prominence Health Plan
Prominence Health is a widely used insurance provider for many of our local Northern NV residents and patients, although no longer accepted at major hospitals and healthcare facilities. We’d like to reassure our community and patients that we proudly continue to accept Prominence Health for all your ear, nose and throat needs and conditions.
- Sierra Health and Life
- Tricare
- United Healthcare
We recommend that you contact your insurance provider to determine your specific benefits, including deductibles, co-insurance and co-payment policies. Our team at Sierra Nevada Ear, Nose & Throat will be happy to answer and assist you with any questions you may have about your insurance benefits.
Proudly Serving the Northern NV Area
With multiple locations in Northern Nevada, including Carson City, Gardnerville and Fallon, we are committed to getting you the ENT care you’ve come to expect when visiting us.
Please contact us at 775-883-7666 to schedule your appointment or talk with our team today.
As a Medicaid or NC Health Choice beneficiary, you fall into one of three categories: To learn more about NC Medicaid Managed Care, go to the
NC Medicaid Managed Care Website. Some beneficiaries can choose to stay in NC Medicaid Direct. This means you are not required to choose a health plan and a PCP. NCDHHS - Division of Health Benefits will send you a letter that tells you if you have the
choice to enroll. You have the option to choose a health plan if you:NC Medicaid Managed Care – Mandatory
Most beneficiaries receiving Medicaid or NC Health Choice will be required to transition to NC Medicaid Managed Care. This means you must choose a health plan and a Primary Care Provider (PCP). If you must choose, NCDHHS - Division of Health Benefits will send you a letter that tells you how to transition to Managed Care. You will be required to transition to NC Medicaid Managed Care if you:NC Medicaid Managed Care – Exempt
NC Medicaid Managed Care – Excluded (NC Medicaid Direct)
- Some
beneficiaries will remain in NC Medicaid Direct, which is the “fee-for-service” program. This is how you receive health care services now. This means you cannot choose a health plan and you do not need to choose a new PCP unless you want to change to your current PCP. You will stay in NC Medicaid Direct if you:
- Receive Family Planning Medicaid, Refugee Medicaid, Foster Care/Adoption Medicaid , or must meet a deductible before getting Medicaid benefits
- Are part of the Health insurance premium payment (HIPP) or Program of all-inclusive care for the elderly (PACE) programs, or
- Have both Medicare and Medicaid or receive long-stay nursing home services,
- Receive Innovations Waiver services, Traumatic Brain Injury (TBI) Waiver services, or Community Alternatives Program for Children (CAP/C) or Community Alternative Program for Disabled Adults (CAP/DA) services.
Contact
TurningPoint Healthcare Solutions
Sunshine Health has contracted with TurningPoint Healthcare Solutions, LLC for Ear, Nose and Throat Surgical Procedures, effective October 15, 2021, for Ambetter (Marketplace) and Allwell (Medicare).
Effective December 1, 2021, the program will apply to Sunshine Health’s Medicaid and Children’s Medical Services (CMS) Health Plan members.
The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for Sunshine Health members.
Sunshine Health oversees the new Ear, Nose and Throat Program and is responsible for claims adjudication. Prior Authorization for medical necessity and appropriate length of stay (when applicable) has been delegated to TurningPoint Healthcare Solutions, LLC. and will be required for the following surgical procedures in both inpatient and outpatient settings.
Ear, Nose and Throat (ENT)
- Tonsillectomy &/or Adenoidectomy
- Sinus Surgery
- Rhinoplasty, Septoplasty
- Laryngoscopy/Laryngoplasty
- Cochlear Device (hearing)
- Tympanostomy/Tympanoplasty
- Thyroidectomy/Parathyroidectomy
- Balloon Dilation Esophagoscopy
For information on Prior Authorizations, please visit our Pre-Auth Check Tool page to see if a pre-authorization is needed. It's quick and easy. If an authorization is needed, you can access our login to submit online.