Billing Breaks It Down: Understanding Medical Insurance Benefits

Nesin Therapy Keeping It Healthy

Written by: Nesin Billing Department

Insurance can be a difficult concept to understand- cue the ladies of our Billing Department on the left! There are so many words and procedures that just do not make sense and you are not alone in your confusion. Insurance Benefits is what your insurance will cover for any of your medical services. What we give you before your initial evaluation is a Quote of what those benefits are, and are based on how we bill and what your insurance states that they will cover.

Common Terminology
  • Copay- A fixed amount ($20, ie) you are responsible for each visit.
  • Deductible- The amount you pay before your insurance plan starts to pay.
  • Coinsurance- The percentage amount (20%, ie ) you are responsible for after you pay your deductible.
  • Out-of-pocket Maximum: The maximum amount you will spend out of pocket per year for your health services. 
  • In-network: This term refers to physicians and medical establishments that are covered under the insurance plan. These providers are generally the cheapest option for policyholders. 
  • Out-of-network: This term refers to physicians and medical establishments not covered under your insurance plan. Services from out-of-network providers are usually more expensive.
It’s that time of year!

A lot of you are meeting your deductibles. What this means for you is now that it is met, your insurance will start paying a portion of your charges and you will be responsible for the remaining portion they do not cover. Deductibles and balances are your responsibility, and are due at time of services.

How to Pay your Balance?

You can pay your balance by going online to your patient portal on our websites, coming in person to our clinics, or mailing in payments. You can also contact our billing team for questions, concerns or to make a payment at 256-489-3760 or email us at