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  Shelby Leith   October 18, 2016   Allowable charges, Medical Billing 0 Comments

Understanding your medical billing: What does ‘allowable charges’ mean?

Make sense of the charges associated with your medical care


What does ‘allowable charges’ mean?Being sick or taking care of family members when they are ill can be stressful enough without the hassle of dealing with medical invoices and insurance companies. At Velocity Care, we strive to make your visit as stress-free as possible by helping you understand some of the key terms that insurance companies and medical professionals use including what does allowable charges mean. Understanding your medical billing is important knowledge to have, especially to you as a patient.

 

What is the definition of allowable charges?

Allowable charges is the term used to define the maximum amount that an insurance company will pay to a doctor’s office for a specific service or treatment. Every type of treatment and service is assigned a specific amount that insurance companies will pay. Third-party insurance companies predetermine the maximum amount they will pay for each type of service. They will reimburse the doctor for that amount, minus any copay or deductible that is the responsibility of the patient.

What if the amount the doctor charges is more than what my medical insurance pays?

Often, the amount that is deemed an appropriate charge by the doctor’s office is more than what an insurance company will pay for that service. In these situations, the doctor must absorb this cost difference and consider it a write-off. If this occurs, the doctor must accept this loss and is not permitted to charge the remaining difference to the patient.

Will my insurance pay for me to visit any doctor or clinic?

It is very important to know exactly which hospitals, clinics and doctors are members of your health insurance network. Most insurance companies deal with specific health care providers, and it is important that you know which ones these are. If you visit a doctor that is not a member of your network, you will be responsible for 100 percent of the charges incurred there.

Dealing with medical billing and insurance companies can be confusing, especially when you are suffering from an illness or injury. At Velocity Care Urgent Treatment Center, we want your primary concern to be getting well, while we focus on taking care of the rest. We are here to answer questions about your health or to help you understand your medical billing.

Uninsured patients benefit from saving money with the Value Card.

Photo credit: 123RF Stock Photo

Medical disclaimer

This site offers medical, health, fitness and nutritional information and is designed for educational purposes only. General information found on this website is not intended to diagnose any medical condition or to replace your health care professional.

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