Question 1

Do you accept my insurance?

Accepted Answer

While we are contracted with most insurance carriers, PPOs, and Medicare, we always recommend giving your health insurance plan provider a call to confirm your coverage and benefits. The number can be found on your insurance card. Please note that Medicare and Medi-Cal are only accepted in select locations. Out-of-network service and benefit coverage can vary based on geographic location or between an urgent or primary care visit.

Question 2

What are co-pays?

Accepted Answer

A co-pay, short for copayment, is a fixed amount a healthcare beneficiary pays for covered medical services. The remaining balance is covered by the patient's insurance company. Co-pays typically vary for different services within the same plans, particularly when they involve services that are considered essential or routine and others that are considered to be less routine or in the domain of a specialist. Co-pays for standard doctor visits are typically lower than those for specialists. Note that copays for emergency room visits tend to be the highest.

Question 3

What are deductibles?

Accepted Answer

A deductible is a fixed amount a patient must pay each year before their health insurance benefits begin to cover the costs. After meeting a deductible, beneficiaries typically pay coinsurance—a certain percentage of costs—for any services that are covered by the plan. They continue to pay the coinsurance until they meet their out-of-pocket maximum for the year.

Question 4

What does it mean if my insurance is not verified?

Accepted Answer

When you come in for your visit, our team will take your insurance information and quickly check the status of your coverage with your insurance provider. There may be times when an insurance plan can’t be verified. For example, your insurance information may be inaccurate or out of date, or the insurance company’s eligibility system may not respond. In cases where we are unable to verify your insurance at the time of your visit, we will charge you the flat rate for this service. These rates are standard and vary by treatment type. You can find them https://carbonhealth.com/insurance-pricing . As a courtesy, we will submit your claim to your insurance company after your visit. Please check the Carbon Health app for a status on your bill, which may be adjusted based on total treatment costs and your insurance benefits.

Question 5

Why is Carbon Health out-of-network with my plan?

Accepted Answer

Out-of-network service and benefit coverage can vary based on contract status, geographic location, or the type of care visit (urgent or primary). While we are contracted with most insurance carriers, PPOs, and Medicare,  we always recommend giving your health insurance plan provider a call to confirm your coverage and benefits. The number can be found on your plan card.

Question 6

My plan has coverage for out-of-network services. Why do I have to pay up-front?

Accepted Answer

We always suggest checking with your insurance company about your out-of-network coverage and benefits before seeking care. Our policy is to estimate your payment by charging our flat self-pay rate for your treatment prior to the visit. You can check out our flat self-pay rates at https://carbonhealth.com/insurance-pricing   or inquire at the front desk before we request payment for your visit. Many insurance companies will still reimburse for out-of-network care at Carbon Health. As a courtesy, we will submit your insurance claim and refund you the balance depending on your benefit.

Question 7

I have questions about my bill. Who can I talk to?

Accepted Answer

If you have any questions about your bill or claim, please contact us at https://support.carbonhealth.com /contact/contact-us .

Question 8

How does Carbon Health come up with their self-pay prices?

Accepted Answer

We look at comparable services in a market, healthcare costs, and also factor in inflation. Our goal is to remain affordable and accessible to the average patient, while ensuring our clinic teams are fairly compensated for the services they provide.

Question 9

Why do Carbon Health's self-pay prices vary by state?

Accepted Answer

Like most healthcare providers, our ability to offer accessible costs to patients often depends on geography. Some factors that affect pricing across states or regions include labor costs, staffing costs, cost of living differences, and other healthcare market dynamics. Our team strives to be clear and straightforward with you about our self-pay fees, and you can always look them up here: https://carbonhealth.com/insurance-pricing .

We accept most major insurance plans. No insurance? See our clear prices before you book.

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