INSURANCE DEDUCTIBLES & CO-INSURANCE

some insurance policies have a patient pay a deductible before they begin to cover the amount varies per insurance and per insurance policy often times when they have a deductible, they also have a co insurance meaning they will cover x% and the patient will be responsible for y% after their deductible is met if their deductible applies to chiropractic, the insurance company will not begin to cover anything until the deductible has been met some insurance companies have a set co payment after the deductible is met you have to make sure you get the correct information when you call to verify the patient's benefits allowed fees this is the maximum amount an insurance carrier will pay for a certain service that's how we calculate what a patient is responsible for per visit example 1 mary jones deductible $500 met $400 left to meet $100 this means ms jones will have to pay the first $100 of her services in our office in order to meet her deductible after she pays the remaining $100, her insurance will cover 80% ms jones will now only be responsible for 20% instead of the whole allowed fee example 2 lisa smith deductible $1000 met $735 00 left to meet $265 00 insurance will pay 70% after deductible patient responsibility for after deductible often, when a patient has a large deductible of $2000 or more, we give them the option to be a cash patient, since it will be more affordable and if they are on a maintenance case, it does not have to billed with the insurance