Insurance & Patient Responsibility
Review the policy details below for current patient information, privacy, accessibility, pricing, and compliance practices.
Your health insurance plan determines your deductible, copay, coinsurance, covered services, and other patient responsibility. CLAPS MD does not set these amounts.
Before a visit, we verify your benefits and use the information provided by your insurer to estimate what you are expected to pay.
Some healthcare organizations wait until after insurance processes a claim before billing the patient. As an independent practice, CLAPS MD generally collects the best available estimate of your patient responsibility at the time of service. This gives patients earlier visibility into expected costs, keeps billing straightforward, and allows more practice resources to remain focused on patient care rather than repeated billing and collection activity. We collect the best available estimate when services are provided and reconcile the account after your insurance company processes the claim.
After your insurer processes the claim, we reconcile your account using the Explanation of Benefits (EOB). If the final patient responsibility is higher than the amount collected, the remaining balance will be due. If the amount collected is higher than the final patient responsibility, the excess will be credited to your account and a refund may be issued when appropriate.
Insurance eligibility and benefit information are estimates and are not a guarantee of coverage or payment.
How our billing process works:
- Deductibles, copays, and coinsurance are determined by your health plan
- Estimated patient responsibility may be collected at the time of service
- Your account is reconciled after your insurer processes the claim
- Remaining balances are due after insurance processing
- Overpayments are credited and may be refunded when appropriate
- A secure card on file may be required under our financial policy
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