So, how do you calculate my copay?

We consider the most current information we have for your plan. If we have very little information available, we will estimate based on similar plans and utilize the breakdown of benefits provided by your insurance company which shows a range of common procedures and the percentages that they allow for each (100% for procedure A, 80% for procedure B, 50% for procedure C covered up to the annual maximum). The benefit information your insurance provides is by no means comprehensive and does not include their allowable fees for each procedure, so the more you and others with your plan use it, the more accurately we can estimate your out-of-pocket expenses. All copayments collected are an estimate; sometimes the insurance may pay more or less than we assess. If they pay more, we will let you know, and you can request a refund check. If they pay less than we estimate, we’ll send you a statement, and you will be responsible for the charges.

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