Insurance Navigation

Understanding The Specifics

 

**This page was designed to help you navigate the specifics of your insurance. Insurance details vary greatly from plan to plan so feel free to call us at (610) 241-2685 for more details on your plan!**

Commonly Used Insurance Terms!

Insurance vocabulary can be tricky but we're here to help!

Co-Insurance

Refers to a percentage of cost for which you are responsible. This is an arrangement with the insurance company to share payment for health care services. This is after any deductible is met. An example of a co-insurance split if 90/10 in which 90% is covered by the insurance plan.

 

Example: A patient that has a 10% co-insurance would pay $10 on a service that costs $100.

Deductible

Refers to a fixed amount you are responsible for paying before the insurance company begins to pay for services. This is typically an annual total.

 

 

Example: A patient with a $800 deductible will pay the first $800 of associated charges before the insurance plan starts contributing.

Co-Pay

Refers to a fixed amount set by an insurance company that you would pay on each date of service. However, if your plan has a deductible, the deductible must be met first. Common copays are $15, $25, or $30.

 

Example: A patient with a $15 co-pay will be charged $15 at each visit.

Out-of-pocket Maximums

Refers to the highest amount you can be expected to pay. The insurance plan will pay 100% after this is met. Most insurance plans set a yearly out-of-pocket maximum.

 

Example: If a patient has an out-of-pocket maximum of $5,000, the insurance plan will pay 100% of expenses once the patient has contributed $5,000 towards all types of qualifying payments (deductible, co-insurance, co-payments).

 


FAQ's

I'm not sure if I have a $20 or $30 co-pay?

Our Support Specialists will review your insurance prior to your first visit. Once the insurance is verified by our team, we will give you a call and walk you through all of the coverage details with your individual insurance.


What if my Insurance has a Co-pay?

We will confirm with your insurance and let you know the amount of your co-pay. Co-pays are due at time of service.


What if I have a High-Deductible Plan?

Not a problem! We will help you stay up-to-date with your balance by providing you with an account summary. Please do not hesitate to ask our front desk for this if you are unsure of your current balance. Payment is recommended at time of each visit to assist with keeping your balance as low as possible!


How will I make a payment for your services?

In person we accept Cash, Check, Credit/Debit Cards and even HSA cards as a form of payment! Our support team is able process payment over the phone as well.


Do you have customer service?

Of course! Our friendly and knowledgeable Support Specialists are available to answer your questions at (P) 610-241-2685


I have another Question...

We're hear to help! Give us a call and we can talk further to answer any and all unique questions!