Estimate Explanations

Please note, estimates are based on expected services to help you financially plan. The cost information provided on these estimates are not a guarantee. The final bill you receive may vary from an estimate for many reasons, including:

• The patient’s medical condition, known circumstances, complications, final diagnosis, and recommended treatment ordered by the physician.
• Additional professional fees, from a physician, radiologist, anesthesiologist, or pathologist may not be included in an estimate.
• Insurance benefit information (where applicable), which is based on details provided by your insurance company as of the date of the estimate. Benefits and eligibility are subject to change and are not a guarantee of payment.

The Northern Light Health affiliate providing the service. This may not be the physical location where you receive the service.

The estimated charges for direct/indirect equipment and space used to perform the procedure or service.

The estimated charges for the services provided by medical providers (these fees include services by all providers associated with care, such as the provider performing the procedure, those reviewing the imaging/labs, providing anesthesia, etc.) 

The estimated rate your insurance company has agreed to pay for each service provided (minus the remaining deductible, co-insurance, or co-pay).

An amount you could owe during a coverage period (usually one year) for covered healthcare services before your insurance plan begins to pay. An overall deductible applies to all or almost all covered items and services. A plan may also have separate deductibles that apply to specific services or groups of services. (For example, if your deductible is $1,000, your plan may apply a portion or all of that amount towards the payment you are responsible for until the deductible is met in full.)

A fixed amount you pay for a covered healthcare service

You and your healthcare provider share this cost. Co-insurance is calculated as a percentage of the insurances allowed for the service. For example, if the health insurance or plan’s allowed amount for an office visit is $100, your coinsurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount, if no other copayment or deductible is required.

The amount your insurance company requires you to pay before you are no longer subject to co-insurance

The estimated total amount the patient is responsible for paying

The 20% discount offered to patients by Northern Light Health for in-scope services if the full amount is paid at once, upfront, and within seven days of service.

The common language used by healthcare providers and insurances to identify specific medical services and procedures.

The common language used by healthcare providers and insurances to identify specific medical services and procedures.

The estimated rate your insurance company has agreed to pay for each service provided (minus the remaining deductible, co-insurance, or co-pay).

The estimated rate your insurance company has agreed to pay for each service provided (minus the remaining deductible, co-insurance, or co-pay).