As a medical practice, we strongly believe our patients deserve the best possible medical care we can provide. In an effort to maintain a high quality of care, we would like to share some of our frequently asked questions about medical insurance.
- Can you tell me what my insurance covers?
It is always best to check your benefits coverage with your insurance company.
Typically, routine or well child services are covered by most insurance companies. Immunizations are billed and sometimes paid for separately. Although an insurance company may pay for the well check, immunizations may not be covered. This is dependent on your plan. Insurance companies may change your coverage and those changes are not always communicated with your doctor. Should questions arise about your medical insurance benefits, it is best for you to contact your insurance company directly or your employer.
- What is my copay?
A copay (or copayment) is a flat fee that you pay on the spot each time you go to your doctor or fill a prescription. We use the insurance information on file to charge you a copay for your visit. Please be sure to provide us with your latest insurance information should to ensure proper billing.
- What is an EOB and how does it affect billing?An EOB is an “explanation of benefits” that outlines the amount covered by insurance and the final amount owed by the patient. Our billing is dependent on receiving an EOB from your insurance company once your claim is processed. This processing time can take anywhere from a few days to a couple of months. Once an EOB is received, if there is a remaining balance due from the patient, we proceed to send out a bill in the amount outlined by the insurance company.