FOR INSURED INDIVIDUALS
Inspire Diagnostics is providing COVID-19 testing with no out-of-pocket cost to the individual. (Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered). The Federal Cares Act is no longer covering the cost of COVID-19 testing and vaccination for the uninsured. However, under the Cares Act, all private, Medicare and Medi-Caid plans are required to cover COVID-19 testing with “no pocket of pocket” costs to their members. We accept the reimbursed amount from the insurance company. There is no amount owed by you to Inspire Diagnostics. If your school district has prearranged with Inspire Diagnostics to cover the cost of testing, Inspire will not be billing individual insurance. If the insurance information is incomplete or not provided, Inspire will perform an Insurance Discovery for accurate information which is needed to submit a claim to the insurance company.
Insurance companies commonly send an Explanation of Benefits (EOB) to their insured members showing the amount of benefit paid under their plan. Healthcare providers, including Inspire Diagnostics, submit claims at standard rates. Often, insurance companies reimburse at significant lower amounts. An EOB may show the difference between the standard charge and actual reimbursed amount as an adjustment or patient responsibility. An EOB, however, is not an invoice.
WHY DID I RECEIVE A CHECK FROM MY INSURANCE?
Certain plans reimburse the insured member instead of the healthcare provider. This occurs mostly in cases in which the healthcare provider is out of network with that plan. In these cases, we would ask that, if you receive payment from your plan, please deposit the check and send the same amount to Inspire Diagnostics. Please note the name of the person so that we can ensure the payment is applied to the proper claim.
We recommend that the insured member of an out of network health plan contact the member services and request that the reimbursement payments are routed directly to Inspire.