Payers require Apollo to bill patients for any applicable deductible, outstanding balance, and co-insurance, as reflected on EOBs or similar statements furnished by the payer. The amounts are determined by the patient’s insurers, not by Apollo. Patients will receive a patient statement from Apollo, which will indicate the balance due for the testing services provided.
Payers require Apollo to register with them at first and then process applications to get credentialed. When credentialed, a contracted reimbursement rate is generally established with the payer.
Apollo bills patient for the amount designated by their plan as the patient’s responsibility, including and balances remaining on the bill if the payer pays less than the “usual and customary,” “reasonable” or “allowable” charge (collectively termed the “Allowable Charge”) for the service provided. The payer will determine the Allowable Charge on the EOB. If the full Allowable Charge is paid to Apollo by the payer, patient will not be billed by Apollo.