Your bill, explained

Healthcare bills can be confusing, partly because three different organizations — the clinic, your insurance plan, and you — all play a role in what the final number looks like. Here's how the pieces fit together.

Step one: the charge

Every service has a list price — the charge. Charges are set in advance and don't depend on which insurance you have. Most patients never pay the full charge, but it's the starting number on the statement.

Step two: the insurance adjustment

If you have insurance, we send the claim to your plan. Your plan applies a negotiated discount called an adjustment. This is the difference between our list price and the rate your plan has agreed to pay us. You don't owe the adjustment — it's between us and the insurance company.

Step three: what insurance pays

After the adjustment, your plan pays its share. How much depends on your plan's rules and where you are in your benefit year:

• Deductible: the amount you pay out of pocket before insurance starts paying. Until you hit it, you're paying.
• Coinsurance: after you've hit your deductible, you pay a percentage (often 10–20%) and the plan pays the rest.
• Copay: a flat fee for certain visit types — common for primary care and urgent care.
• Out-of-pocket maximum: once you've paid this amount in a calendar year, the plan covers 100%.

Step four: your responsibility

What's left after the adjustment and insurance payment is your patient responsibility. That's the number you actually owe. It shows up on your patient statement, with itemized lines for each service.

If something looks wrong

Mistakes happen. If a line on your bill doesn't match what you remember from the visit, or if you received a bill for a service you don't recognize, please reach out before paying. The fastest paths are:

• Message billing through the patient portal. Most replies are same-day during business hours.
• Submit a question via our contact form if you don't yet have portal access.

If you can't afford to pay

Ored Health Network offers payment plans (interest-free, monthly) and financial assistance for patients who qualify based on household income. Don't avoid getting care because of cost — talk to our patient financial services team. You can start the conversation through the portal or contact form.