Explanation of your billing statement

The image and descriptions below explain your statement. Scroll below the image for a key to the numbers in blue on the statement presented here.

1. Account Number
2. Balance Due
3. Encounter Number
4. Insurance Activity
5. Patient Portion
6. Return Payment Coupon

1. Account Number
Please be sure to include your account number on all written correspondence and have it ready if you call us.

2. Balance Due
This shows the portion of your charges that you are responsible for. Charges that have not yet been considered by insurance are not included in this balance.

3. Encounter Number
The Encounter Number is a reference number for each unique visit that you have. This number "ties together" charges, payments, and adjustments as they are itemized on your statement.

4. Insurance Activity
Any charges that are pending for insurance payment will not appear on your statement until insurance has considered your claim. When we receive the payment and/or Explanation of Benefit, any charges, payments, and adjustments for the claim will be itemized in this column.

5. Patient Portion
After insurance has considered your claim, any deductible, co-insurance, etc., will be transferred to the Patient Portion of your bill to help identify what you owe.

6. Return Payment Coupon
Please detach on the perforation and return the top portion of your statement along with your payment.