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Common Terms & FAQs

Let’s face it – healthcare can be confusing. There are many different terms that make it difficult to understand what is covered by your insurer and what you are responsible to pay. Check out these definitions of commonly used healthcare insurance terms from Healthcare.gov to better understand your healthcare responsibility. 

Deductible: 

The amount you pay for covered healthcare services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services. Your insurance company pays the rest. 

Co-Payment:

A fixed amount ($20, for example) you pay for a covered healthcare service after you’ve paid your deductible. Let’s say your health insurance plan’s allowable cost for a doctor’s office visit is $100, and your copayment for a doctor visit is $20. 

• If you’ve paid your deductible: You pay $20, usually at the time of the visit.
• If you haven’t met your deductible: You pay $100, the full allowable amount for the visit.

Co-payments (sometimes called “co-pays”): 

Can vary for different services within the same plan, like drugs, lab tests, and visits to specialists. 

Coinsurance: 

The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible. Let’s say your health insurance plan’s allowed amount for an office visit is $100 and your coinsurance is 20%. 

• If you’ve paid your deductible: You pay 20% of $100, or $20. The insurance company pays the rest.
• If you haven’t met your deductible: You pay the full allowed amount, $100.

Out-of-Pocket Maximum/Limit: 

The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits. The out-of-pocket limit doesn’t include your monthly premiums. It also doesn’t include anything you spend for services your plan doesn’t cover.

BIlLING AND PAYMENT FAQ’S

Does My Insurance Cover Home Infusion?

Our office will call your insurance, verify your benefits, verify if your deductible is met and if you have an out of pocket amount that you need to meet before your insurance pays in full. We will then notify you of your estimated charges and out of pocket amounts BEFORE the start of your therapy. We will make sure you are clear, your questions are answered, and you agree to your financial responsibility before we schedule you for therapy.

Will you send me a bill to let me know what I owe? 

After your treatment, you will receive an explanation of benefits (EOB) from your health plan that will confirm your payment responsibility. We receive the same letter within 30-60 days following your treatment. We will review each EOB carefully and send you a statement outlining what you owe us. If you have given us permission to charge your credit card automatically for balance owed, we will only charge the amount that is determined by your health plan to be your responsibility. 

What happens if I need to dispute my bill? 

Just call us! We will only charge you the amount determined by your health plan in your EOB. However, we will work with you if there has been a mistake on your bill, and refund you the necessary amount to correct any error. 

What If I Can’t Afford My Infusion Therapy?

Please call us with financial concerns, we will work with you.

GENERAL HOME INFUSION FAQs

What Is Infusion Therapy?

Infusion therapy involves the administration of medication through a needle or catheter. It is prescribed when a patient’s condition cannot be treated effectively by oral medications.

Why Are Infusions Performed At Home?

Heightened emphasis on cost-containment in health care, as well as developments in the clinical administration of the therapy, led to strategies to administer infusion therapy in alternate settings. For individuals requiring long-term therapy, inpatient care is not only tremendously expensive but also prevents the individual from resuming normal lifestyle and work activities.

The technological advances that enabled safe and effective administration of infusion therapies in the home, the desire of patients to resume normal lifestyles and work activities while recovering from illness, and the cost-effectiveness of home care are important. Consequently, home infusion therapy has evolved into a comprehensive medical therapy that is a much less costly alternative to inpatient treatment in a hospital or skilled nursing facility.

Home infusion has been proven to be a safe and effective alternative to inpatient care for many disease states and therapies. For many patients, receiving treatment at home or in an outpatient infusion suite setting is preferable to inpatient care. A thorough patient assessment and home assessment are performed before initiating infusion therapy at home to ensure that the patient is an appropriate candidate for home care.

How Frequently Does The Home Infusion Nurse Visit? 

Each patient care plan is customized to the needs of the individual. Our nurse will discuss your care schedule with you during the first visit. At your initial evaluation, our nurse will determine the timing and frequency of visits based on your needs.

Will I get blood drawn for my labs in my home?

Nevada Infusion Nurses can draw blood in the home as part of a patient’s ongoing plan of care.

Is Home Infusion Therapy Safe?

Home infusion has been proven to be a safe and effective alternative to inpatient care for many disease states and therapies. For many patients, receiving treatment at home or in an outpatient infusion suite setting is preferable to inpatient care. Nevada Infusion operates two private ambulatory infusion suites, which are ideally suited for certain patient-therapy situations.

Can I Work While I Am On Home Infusion Therapy?

Yes! You can work. Whenever possible, we work as a team with you and your physician to make your infusion times fit into your schedule, not ours.

Do I Have To Sit In One Place And Stay Still While I Am Receiving My I.V. Therapy? 

It depends on the type of therapy you are receiving, but in most cases you are extremely mobile.

How Do I Store My Medication?

Check the label, and call us if you have any questions, but most of the time medications should be kept in the refrigerator and not the freezer.

What Happens If I Damage A Dose Of My Medication?

Please contact us right away, especially if it is your last dose.

How Long Is My Medication Good After I Get It?

Every medication has an expiration date, so your medication will need to be used before the expiration date. The expiration date is listed on the label of each dose of medication.

Should I Be Worried If My Medication Has Been Sitting Outside, On My Doorstep, During Hot Or Cold Weather?

If you have concerns about the condition of your medication contact us right away.