Important Insurance Terms

1. Copay
A copay is a set amount you pay at the time of your child’s visit.
Example: You might pay $25 each time your child sees the doctor, no matter the total cost of the visit.

2. Coinsurance
Coinsurance is a percentage of the medical bill you pay after your deductible has been met.
Example: If your insurance pays 80%, you may pay the remaining 20% of the visit cost.

3. Deductible
A deductible is the amount you must pay out of your own pocket each year before your insurance starts covering costs.
Example: If your deductible is $1,000, you’ll need to pay that amount first (through visits, procedures, etc.) before your insurance begins to pay its share.

4. Timely Filing: 



The deadline insurance companies give for medical offices to submit claims after your child’s visit. Each insurance company has its own time limit, which can range from 90 days to 1 year after the date of service. If a claim is submitted after that deadline, the insurance may deny payment, and the balance could become your responsibility. This is why it is important to provide updated insurance when/if it changes.