What does the payment process look like from doctor’s visit to settlement?

There are some important things to remember when using your CDHP that is coupled with a QHDHP:

  • Present your medical ID card every time your access medical services or products. Without it, you will pay retail when you are entitled to wholesale costs, which are negotiated by your health insurance carrier.
  • Never pay for medical services at the doctor’s office, even if the receptionist asks that you do. If your doctor participates with your health plan, they have a contract with your insurance company that requires them to give you a pre-negotiated discount, which will be calculated through your insurer when they adjudicate claims.
  • Pay for medical services after you receive your EOB—you are paying the total amount listed on your EOB, not your doctor’s bill, and there may be significant differences between the two.
  • You may be asked to pay the discounted price of a drug at the pharmacy. In this case, pay with your healthcare account’s debit card if available, or submit the bill to your healthcare account administrator for reimbursement.

Coaches' Takeaway

Because the payment process is different from what you are used to, please refer to the above flow chart.

Tools & Resources

CDHPCoach’s Storage Facility, where the Coach has organized and compiled a vast amount of tools and resources for you to access.

Library

Housed here are key components and information within the book, Bend the Healthcare Trend which was the impetus behind the CDHPCoach.