If you are visiting an in-network physician or provider, your costs will depend on the provider’s negotiated rate with your insurer. If you are visiting an out-of-network provider, then you might be charged at the point of service. For in-network care, never pay for medical services at the doctor’s office unless they have the ability to do real-time claim adjudication and can show you what they billed the insurance company and what the contracted or allowed amount is for your visit. Most doctors’ offices don’t have this technology yet.

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 claims are adjudicated, and you will be responsible for paying that contracted amount once you receive your EOB.

Each time you go to the doctor, you should present your medical ID card. In most cases, you won’t pay for the service on the spot, as you would with most traditional health plans. Instead, your doctor will submit the bill to your health insurance provider. The insurer then adjudicates the claim and sends you an EOB that tells how much you owe for the service. At this point, you call your doctor’s office and provide the healthcare account debit card information, write a check, or file a paper claim for reimbursement.

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

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