Member Liability Estimate
The link below initiates the process for obtaining a member liability estimate. This process will provide you with a estimated member share amount at the point of care, while the patient is still in your office, prior to claim submission. This feature enables your office to collect copayments, coinsurance and deductible amounts up front, rather than waiting until the claim is processed to reconcile your patient accounts.
In order to continue retrieving this estimate, you will need to have several data elements related to provider specific information, member/patient information, and details of the services to be rendered, including but not limited to: diagnosis, procedure, modifier, charges, etc. You will be prompted for these elements via an interactive template. If at any time you are not able to supply the required elements in the template, you will not be able to obtain an estimate.
Unless otherwise required by state law, this notice is not a guarantee of payment. Benefits are subject to all contract limits and the member’s status on the date of service. Accumulated amounts such as deductible may change as additional claims are processed.