What is a Date of Service (DOS)?

• The Date of Service, DOS, is when the medical service was provided (i.e., the appointment date).

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What is an Explanation of Benefits (EOB)?

• It is a document from your insurance company that breaks down what your carrier covers and what they expect you to pay. Insurance companies provide this document to physicians when they remit payment; the insurance also provides this document to patients.

 

What is a Copay?

• A copay is a set flat rate for a service, such as an office visit, procedure, or lab. Copays may be higher for specialist visits than for primary care offices.

 

What is a Coinsurance

• A percentage cost of a service, such as an office visit, procedure, or lab work.

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What is a Deductible

• A patient must pay a set amount—a deductible—before insurance starts to cover certain services. Before meeting your deductible, you are responsible for medical charges. After you meet your deductible, the amount your insurance covers will vary based on your plan.

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Why was my copay different from expected?

• Our insurance verifier determines copays, coinsurances, and deductibles—collectively called "patient responsibility"—before your visit, either through an online portal with your insurance or via a phone call. The portals that determine patient responsibility and the customer service representatives on phone calls do not always provide accurate information. If an error occurs at this step, it is corrected after your insurance processes the claim and submits an Explanation of Benefits (EOB).

• Depending on your insurance plan, lab work and/or procedures may or may not be covered by your usual copay.

• Another reason your responsibility may differ is due to a credit or debit on your account.

 

Why do I have a balance or credit?

• Patient responsibility—copays, coinsurances, and deductibles—is estimated based on insurance eligibility portals and/or phone calls with your insurance before your visit. These estimates are not always correct, and after the claim is processed, there may be a balance or credit on your account based on your insurance's final determination (as laid out in your Explanation of Benefits (EOB) from the insurance).

 

Does my copay cover labs (blood work or urine testing)?

• Depending on your insurance plan, labs may be considered part of an office visit (where the usual copay would apply) or as an ancillary service (where a deductible would apply).

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Why did I get a bill from Tribal Diagnostics, LabCorp, or Quest Laboratories for blood testing?

• While Better Life offers in-house phlebotomy (blood draw), it does not process the samples. A third-party lab processes these specimens and sends the office results.

 

Why did I get a bill from Tribal Diagnostics, LabCorp, or Quest Laboratories for urine testing?

• When you submit a urine specimen, it undergoes two different types of tests. One is rapid in-office screening, which is billed by Better Life. The second is a "confirmation" performed by a third party lab (Tribal Diagnostics, Quest, or LabCorp). 

• For billing-related questions that pertain to your lab work, call the number on the invoice from the lab.

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Does my copay cover procedures in the office?  

• Depending on your insurance plan, an in-office procedure may be considered an office visit (where the usual copay would apply) or a surgery (where a deductible would apply).

 

Why did I get a bill from Houston Methodist Hospital, BMC North Hospital, Memorial Hermann Surgery Center, or HCA Hospital?

• If you complete a procedure outside of the office, Better Life will charge you, and the facility where your procedure occurred will charge you separately.

 

Do you have payment plans?

• Payment is due at the time of service.

• Generally, no; we do not offer payment plans. If your insurance company provided an estimated incorrect responsibility of more than $400, our billing team can work with you to resolve the balance over three months.

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How long does it take to process a claim?

• Claims are usually submitted from Better Life to your insurance within one week of the appointment. Some insurances only take seven days to process a claim, but it usually takes 30 to 90 days (or more).

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Can my no-show or late-cancellation fee be waived?

• Yes. Once per year, you can request a no-show or late-cancellation fee waived.

• There is a maximum of one waived no-show fee per year, so please call us at least 48 hours before your scheduled appointment to cancel or reschedule.

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