We understand that navigating health insurance can be confusing. To help you, here's a guide on what happens after you complete your visit with us and how insurance payments are processed.
Step 1: Completion of Your Visit
After your appointment, your doctor and our billing team finalize the details of your visit.
Step 2: Billing Your Insurance
- Claim Submission: We send a claim to your insurance company. This claim includes all the services provided to you during your visit and their respective costs.
- Processing Time: Insurance companies typically take a few weeks to process claims. During this time, they review the services and determine how much of the cost they will cover based on your insurance plan.
Step 3: Insurance Company's Response
- Explanation of Benefits (EOB): Once your insurance processes the claim, they send an Explanation of Benefits (EOB) to both you and our practice. This document is not a bill. It outlines what services were billed, how much your insurance plan covered, and any remaining amount you owe, such as deductibles, co-pays, or co-insurance.
- Payment to Practice: The insurance company also pays us directly for their portion of the services covered under your plan.
Step 4: Your Share of the Payment
- Compute Remaining Balance: After receiving the EOB and payment from your insurance, we compute the remaining balance. If you paid a cost estimate when you booked, we apply that amount against any balance you may owe for the visit.
- Patient Statement: If we determine that you still owe a balance, we generate and send you a patient statement via email. We may also reach out via push notifications, text messages, or mail. If you are unsure about the authenticity of the message, please contact us.
- Making Your Payment: You can pay online with your credit card, debit card, HSA, or FSA.
Tips for a Smooth Process
- Update Your Information: Always ensure your insurance and contact information are up to date on your profile to avoid any delays or incorrect bills.
- Understand Your Insurance Plan: Familiarize yourself with your plan's deductible, co-pay, and co-insurance details. This helps you anticipate potential out-of-pocket costs.
- Review the EOB: When you receive the Explanation of Benefits, review it carefully. If there are discrepancies or if something is unclear, contact your insurance company for clarification.
- Contact Us for Questions: If you have any questions about your bill or need assistance, our billing department is here to help.
Insurance policies vary, and so does coverage for different services. It's important to understand that the insurance process takes time, and we appreciate your patience as we work together with your insurance company to settle your account accurately and efficiently.