Billing Information for Patients – Breg, Inc.

Introduction

At Breg, we understand that billing and insurance claims can be overwhelming for patients. That’s why we’ve created this comprehensive guide to help you navigate the billing process and answer any questions you may have. In this article, we’ll discuss the different types of billing, insurance claims, and payment options available to you. We’ll also provide you with helpful tips and resources to make the billing process as smooth as possible.

Billing Definitions

Before we dive into the billing process, it’s important to understand some key terms and definitions. Here are a few things you should know:

• CPT Code: CPT stands for Current Procedural Terminology. It’s a code used to identify a specific medical service or procedure. Your healthcare provider will use CPT codes to bill your insurance company for the services they provide.
• HCPCS Code: HCPCS stands for Healthcare Common Procedure Coding System. It’s a code used to identify medical equipment and supplies, like braces and orthotics.
• ICD-10 Code: ICD-10 stands for International Classification of Diseases, 10th Revision. It’s a code used to identify the medical condition or diagnosis for which you’re receiving treatment.
• Insurance Claim: An insurance claim is a request for payment submitted to your insurance company for medical services or products you’ve received.
• Co-pay: A co-pay is a fixed amount you pay for medical services or products, like a brace or orthotic, at the time of purchase.
• Deductible: A deductible is the amount you must pay out-of-pocket for medical expenses before your insurance coverage kicks in.
• Out-of-pocket Maximum: An out-of-pocket maximum is the maximum amount you’ll pay for medical expenses in a year. Once you reach this amount, your insurance company will pay 100% of covered expenses.

Billing Process

Now that you understand the basics, let’s take a look at the billing process. Here’s what you can expect:

1. Submit a Claim: After you receive your brace or orthotic, your healthcare provider will submit a claim to your insurance company. This claim will include the CPT, HCPCS, and ICD-10 codes relevant to your treatment.
2. Wait for Processing: Your insurance company will review the claim and determine the amount they’ll cover. This process can take anywhere from a few days to several weeks.
3. Receive a Statement: Once the claim has been processed, you’ll receive a statement from Breg with the amount you owe. This statement will include payment options and instructions.
4. Pay Your Bill: You can pay your bill online through the Breg patient portal, by phone, or by mail. We’ll discuss payment options in more detail later in this article.

Insurance Claims

Insurance claims can be tricky, but don’t worry – we’re here to help. Here are some tips to keep in mind when submitting an insurance claim:

• Check Your Coverage: Before you receive your brace or orthotic, make sure you understand your insurance coverage. Check your policy to see what’s covered and what’s not.
• Get Pre-Authorization: In some cases, your healthcare provider may need to get pre-authorization from your insurance company before submitting a claim. This ensures that the service or product is covered under your policy.
• Submit Your Claim: After you receive your brace or orthotic, your healthcare provider will submit a claim to your insurance company. Make sure they have all the necessary information, including your insurance policy number and billing address.
• Follow Up: If you haven