Patient Statement

How to Read Your Billing Statement

  1. Medical group name The medical group name.
  2. Guarantor information Guarantor name, patient account number, and date for this statement.
  3. Account status Message to regarding the insurance status for this statement.
  4. Payment due Amount you currently owe and the date that payment is due.
  5. QuickPay URL and code The QuickPay Portal website URL, and with the QuickPay code you can use to make your payment.
  6. Mail payment information Instructions for how to mail a payment.
  7. Questions? Use this telephone number to reach Orthopedic Associates and ask to speak to the Billing Office.
  8. Additional messages Additional information to help you understand the status of your balance.
  9. E-statement message More information for if you would like to sign up for paperless statements.
Patient Statement

Legend

  1. Medical group name The medical group name.
  2. Guarantor information Guarantor name, patient account number, and date for this statement.
  3. Account status Message to regarding the insurance status for this statement.
  4. Charge detail summary Sum of the statement charges, any insurance or patient payments applied, the outstanding balance, and the due date.
  5. Charge banner Identifies whether the charges below are professional or facility charges, along with descriptions of each.
  6. Patient provider, and service location information
  7. Patient Name Patient who received the service. This name may be different than the guarantor.
  8. Provider Name Rendering provider.
  9. Service Location The department name where the service took place.
  10. Charge details Service description and the amount charged. Any insurance payments or adjustments, patient payments, and provider adjustments. The remaining patient balance is copay, deductible, coinsurance, or Misc.
  11. Total patient balance Displays the total outstanding balance on the account.