If you have insurance coverage, Circle Medical processes a claim for your care after your appointment using the insurance details you have provided. After the claim is sent to your insurance company, they will then process the claim. Once done, they will send you an EOB, which summarizes and breaks down the costs they have calculated.
Circle Medical follows structured steps for insurance billing to ensure transparency and accuracy.
After your provider finalizes their notes, Circle Medical generates a claim and submits it to your insurance provider. Insurance processes the claim, which may take 4-6 weeks or longer.
During this period, the provider determines what you're responsible for paying. Once the insurance claim is processed, an invoice is sent to you, detailing any outstanding balances.
Payment, if applicable, is charged approximately 48 hours after the invoice is sent.
You can review your payment status directly in the Circle Medical app to stay updated on charges.
Understanding Appointment Costs
Appointment costs vary based on several factors: insurance coverage, deductible, copays or coinsurance, and self-pay or uninsured arrangements.
Insurance coverage is explained through deductibles, which are annual amounts you must pay out-of-pocket before full benefits apply.
For those without insurance, Circle Medical offers Video Appointments for $120 per visit.
See our Appointment Costs article for a detailed breakdown of self-pay rates.
Explanation of Benefits (EOB) for Insured Patients
Insurance coverage might not always align with the provider's charges due to negotiated rates. The EOB from your insurance helps you understand what the insurance agrees to pay versus the total cost.
The EOB typically includes:
Service Summary: A glance at the services, total costs, and insurance coverage.
Detailed Breakdown: Specifics of each service, including dates, providers, and individual costs.
Medical Codes: These are standardized codes that are essential for identifying procedures.
Accuracy is Key
It’s vital to review your EOB for accuracy. Contact the number on the back of your insurance card, or the member services line, to voice any discrepancies with your insurance provider. For insured patients, examining the EOB and contacting insurance for clarification may help resolve discrepancies.
Keep in mind that appointment-related charges depend on individual healthcare plans and their details. Reviewing your insurance terms and contacting your insurer are essential steps if discrepancies arise. The Circle Medical Patient Care team does not have access to your insurance plan policy and benefits breakdown.
EOB Components
Name | Definition |
Patient and Provider Information | Your details and those of your healthcare provider. |
Service Details | Information on the healthcare services received. |
Provider Charges | The total billed amount from Circle Medical, and any insurance adjustments. |
Insurance Payments | Details of what your insurance has paid, including deductibles and co-pays. |
Patient Responsibility | Out-of-pocket costs, including remaining deductibles and co-insurance. This is the amount that you are responsible to pay. |
For further assistance, refer to the Circle Medical app to view your invoices or contact the Patient Care team through our HIPAA-compliant chat feature on the mobile app or web portal.