COPAYMENTS AND DEDUCTIBLES
At Marsalis Avenue Urgent Care Clinic, we want to our help patients better understand why they are being charged a certain amount and why these amounts may differ from those charged to other family member or friends.
What is a copayment?
A copayment often referred to as a co-pay is a fixed amount that the patient pays for covered medical services. The remaining balance is covered by the patient's insurance company. Co-pays generally vary for different services within the same plans, particularly when they involve services that are considered essential or routine, and others services that are considered to be less routine, often with a specialist.
What is a deductible?
A deductible is a fixed amount that the patient must pay each year before their health insurance benefits begin to cover the costs of their medical care. After you meet your deductible, the patient(s) may likely pay the coinsurance which is a certain percentage of costs for any services that are covered by the plan. The coinsurance continues to be paid until the out-of-pocket maximum is met for the year.
It is important to understand that a patient’s out of pocket amount is determined by the insurance plan chosen by the policy holder and/or their employer. Some employers offer employees a variety of plans, from several different insurance companies, from which to choose. The cost of the plan is often directly related to the deductible/copayment amounts, the higher the monthly premium, the lower the deductible/co-payments, and vice versa. Rest assured, we charge from a standard fee schedule, and any differences in charges from person-to-person stem from differences in insurance coverage and/or the status of an individual’s deductible at the time of visit. Copayments and deductibles are a contract responsibility between you and your insurance company and are non-negotiable. It is our policy to collect all co-payments and/or any unmet deductible at every visit, during the registration process. If you still have questions regarding your charges, you are encouraged to call our billing office at (214) 432-1450, between 9:00 am – 5:00 p.m., Monday through Friday.