by Kimmy Marsh
You get your mail or check your e-mail and you’ve gotten a statement from Kinetic Edge. You take a look and you’re not sure it’s correct. Now what? Here’s a list of some Frequently Asked Questions we get in the Billing Department to hopefully help you decide what your next step is!
Q: What is a deductible?
A: The amount you pay for covered health care services before your insurance plan starts to pay. For example, if you have a $2,000 deductible, you will be responsible for the first $2,000 and then insurance will help pay after that. Depending on your plan, they could pay 100%, or you could still owe a copay or have coinsurance.
Q: What is coinsurance?
A: Coinsurance is the percentage of costs you pay based on the charges sent to insurance. For example, if you have a coinsurance amount of 20%, your insurance company will pay for 80% and you will be responsible for the 20%.
Q: What is a copay?
A: A copay is the fixed amount you pay per visit. For example, if you have a $25 copay, you will be responsible for $25 at every visit.
Q: I got an EOB (Explanation of Benefits) from my insurance company saying my visits were denied. What do I do now?
A: If you receive an EOB from your insurance company stating that your visits were denied, we also receive that! We have a Claims Specialist on the billing team who works with insurance companies to reprocess claims if they come back denied or incorrect. If we need you to do anything to help reprocess your visits, he will contact you and let you know what information is needed! Most claims we are able to get corrected without needing any help from you!
Q: It looks like my insurance didn’t pay anything and transferred it all to me.
A: If your EOB states that everything got transferred to you, (for example, $201 charged to insurance, $201 is the patient responsibility) this most likely means that your claim was denied by your insurance company. If this happens, our Claims Specialist will appeal it and we work with your insurance company to get this corrected.
Q: I paid $50 a visit. Why am I not seeing that on my statement?
A: If you have a deductible, we ask that you pay $50 a visit to go towards your deductible in the hopes that you won’t get a statement with a large balance. When we apply that $50, it goes to your running balance & not to a specific date of service. Make sure you look at the “Patient Paid” column to make sure our records match up to yours!
Q: My credit card is on file to run, why did I get a statement?
A: While we try to collect payment at every visit, sometimes we miss them! We apologize for the inconvenience to you, but just give us a call & we can run the payment through your saved information!
Q: I have a secondary insurance. Will I still have to pay anything?
A: It depends on what secondary insurance & plan you have.
- If you have Medicaid as a secondary, they will cover the balance.
- If your secondary has a Deductible or Out of Pocket Maximum to reach, you will have to pay that before they will cover at 100%.
- If Medicare is your primary insurance, you might have to cover the yearly Medicare deductible before the secondary will kick in at 100%.
If you have any questions on what your out-of-pocket costs will be, don’t hesitate to call our Corporate Office and talk to our Insurance Specialist!
Q: I thought I paid my statement balance in full, so why did I get another one?
A: Depending on the time of statement printing & you sending in your payment, sometimes they get crossed over in the mail. If you think this happened to you, call our Corporate Office to make sure this was the case & something wasn’t missed on our end!
Q: I got a statement in the mail, but would love e-statements. Can I sign up for those?
A: Absolutely! Just give your clinic a call & let them know that you want to be signed up to get e-statements! You can also opt out if you get e-statements, but would rather get them in the mail!
Q: I got a statement—how can I pay the balance?
A: We have multiple ways you can pay your statement balance!
- Go to www.kineticedgept.com/pay-my-bill/
- Call in to your clinic location or the Corporate Office to make a credit/debit card payment over the phone
- Mail in the payment stub on your statement with a check or your credit/debit card information
- Stop in to your clinic location and pay with cash, check or credit/debit card
Q: Can I set up a payment plan?
A: If you’d like to set up a payment plan for your balance, call our Corporate Office to discuss if this is an option for you! We do our best to work with you to get your balance paid in a timely fashion, while also understanding that life happens!
If you have any other questions about your statement, don’t hesitate to reach out to the Billing Team! Just call 641-204-0046 and let us know your questions or concerns!