At Revitalize Medical Center, we understand how confusing and frustrating insurance and billing can be. Our billing is handled by an outside billing company. If you have any questions, feel free to give us a call and we can provide further direction or provide their contact information. All office visits, telemedicine visits, and in-office procedures at Glenview or Evanston are billed through your insurance first. Then, depending on your insurance plan, you may have a leftover payment to make (either a co-pay or deductible). If you are self-pay, prices for all services will be provided prior to receiving the service.
Here are common billings phrases or words that may be used:
- Deductible: A deductible is the total amount a patient must pay for healthcare services covered by their insurance prior to when their insurance company will begin to cover costs. Your deductible cost depends on your insurance plan. Even Medicare has a deductible that resets every year!
- Coinsurance: A coinsurance is the total percent amount a patient must pay for healthcare services that are by their insurance after they have satisfied the deductible required by their insurance plan. Your coinsurance prices will vary depending on your insurance plan and the healthcare service requested.
- Copayment: A copayment, or “copay”, is a set rate a patient will pay for healthcare services such as office visits, procedures, prescriptions, and more. Copayment prices will vary depending on your insurance plan and the healthcare service requested.
- Explanation of Benefits or “EOB”: Following an office visit or completion of healthcare services or treatments, a healthcare provider submits a claim. This is when the billing process begins. After this claim has been submitted by the healthcare provider, this document (EOB) is sent to insured patients. THIS IS NOT A BILL. An EOB has not yet been processed by your insurance company. An EOB explains what medical treatments or services the patient’s health insurance agreed to pay for and cover, and what is expected that will be left to pay.
Your Medical Bill Explained:
Reading a medical bill can be overwhelming. Here is a breakdown of different parts of a medical bill that you may receive. The majority of our office visits are based on time spent on the day of service. This does not refer to face to face time only. The billed time also includes time the doctor has spent in documentation, reviewing your past records, prior authorizations, discussing your plan with referring providers, or coordinating your care.
- Account Number: A unique number only for you and your account. When contacting the billing company or making a payment, it is important to have this number handy.
- Statement Date: This is the date that the bill is printed on.
- Service Date: This lists the date(s) you received healthcare services.
- Description: An explanation of the healthcare service(s) or supplies you received which are being billed on the statement.
- Charges: These are the full prices of the listed healthcare services you received, prior to any insurance coverage or any payments. This amount is typically greater than the contractual amount for the service. The adjustment will account for this reduction.
- Adjustment: If applicable, any amount the healthcare provider may have waived. This amount is what is deducted from the full charges to then give you the actual billed amount for the service.
- Billed Charges: This is the actual amount billed to your insurance company (not the charges).
- Insurance Payments: This is the amount that has been paid by your health insurance.
- Patient Payments: This is the amount you are responsible to pay after the insurance company has paid their portion. If you have a deductible, then the entire bill may be transferred to you. Again, even Medicare has a deductible!
- Balance/Amount Due: The total amount you currently owe the healthcare providers. This could be more than the above total, if you have past due balances as well.
- Payable To: Where, or to whom, payment should be made to.
For patients whose insurance plans we do not accept or for whom we are out of network with, we offer a discounted self-pay rate. Prices for all services will be provided prior to receiving the service.
Occasionally, an insurance carrier may not provide 100% coverage of services. Refer to your insurance explanation of benefits for details, as this does vary by health insurance plan and patient.
We offer both paper and electronic statements. Payment can be made either online, by mail, or in our office. Electronic statements and payments can be accessed through your Patient Portal, which you receive an invitation to at your first office visit. If needed, we do offer payment plans if patients need to make their payment in smaller amounts rather than all at once. We understand how challenging bills can be and want to make this process as painless as possible for you.
If your procedure is being done at St. Francis Hospital with Dr. DeCaria, please note that these visits are billed separately. We unfortunately do not even see the bill or statement. Questions regarding St. Francis procedure billing can be directed to St. Francis at their Billing Form or by calling 855.MyAMITA. There should also be contact information for St. Francis on your bill from them.
Please call us at 847-834-4018 to schedule your appointment or so we can answer any further questions.