PATIENT RESPONSIBILITY DISCLOSURE
As the new year goes on, our patients are being confronted with subtle changes in their insurance plans. Patient responsibility is newly assigned. Commonly, the new year means Deductibles reset and start again at zero. Many of our patients who had no deductibles in the previous year have them now. A large number of them are “not aware” of these changes and in turn it makes it more challenging to collect on these claims which are not paid by the plan since they represent patient’s responsibilities.
For that reason, we some time have to remind our patients that our participation with Insurance Plans does not imply you as our patient will not get a bill for services rendered during your visits or surgical procedures. Note that your Insurance Policy may have multiple ways to assign the responsibility of our fees to you. This is done through DEDUCTIBLES, COINSURANCE and COPAY. It is important to be familiar with these aspects of your plan to avoid unexpected bills and be able to manage your medical costs efficiently and effectively.
DEDUCTIBLES are assigned as per your policy to ALL SERVICES or just to CERTAIN PROCEDURES. Your insurance will not pay for your claims until the total of your deductible has been satisfied by assigning it to approved claims. These DEDUCTIBLES may range anywhere from a total of $200.00 per year to a total of $5000.00 (or more). Note, most often it will take several claims to satisfy a large deductible. As an example, if one visit claim for a patient was around $350.00 and the total deductible is more than that, then your claim for $350.00 may be payable by you, as per your plan’s provisions. Please be aware of this.
CO-INSURANCE is a percentage (%) of your total approved insurance claim which is billable to you as per your insurance policy. This varies widely through the insurance companies. A common CO-INSURANCE is 20% of the approved claim. Normally coinsurance is due after DEDUCTIBLES have been satisfied.
Additionally, a COPAY is a set amount (anywhere from $5.00 to $75.00 or more) collected from the patient at the time of the visit. This is usually stated on your insurance card. Some plans will specify different amounts for your General Doctor and for Specialists.
We hope this helps keep things clear.