Examples
1. Successful Negotiation
A surgical procedure is needed by yourself or someone in your family. The procedure costs $4,200.00. The surgery center submits the bill to your health insurance. You have a $500 deductible.
Your health insurance subtracts the deductible and $160.00 worth of charges not covered. This leaves $3,540. Your insurance company processes your claim for this amount at the 90% in-network benefit level. The insurance company pays $3,186.00.
You are responsible for your $500 deductible, plus the additional $514 of charges not covered by your insurance. This is a balance of $1,014.00.
On average, INSNET is able to secure a discount of 25% of the balance remaining after insurance coverage. Based on this average, we would secure a discount of $253.50.
The discount is subtracted from your balance due to your medical provider. The surgery center charges your credit/debit card for $760.50. INSNET charges its fee of 35% of the amount saved, which is $88.72. You save $164.78!
The details of the negotiation are emailed to you in our Transaction Summary.
Summary - Example 1
| $4,200.00 | Total cost of service |
| -$500.00 | Your deductible |
| $3,540.00 | Insurance claim amount |
| -$3,186.00 | Paid by insurance at 90% |
| $1,014.00 | Your responsibility |
| -$253.50 | 25% discount negotiated by INSNET |
| $760.50 | Amount paid to hospital |
| $88.72 | INSNET fee |
| $164.68 | You saved! |
2. Provider refuses negotiation
You make a visit to the emergency room and receive a bill for $750. Your emergency room bill is submitted to INSNET for negotiation. The claim is analyzed in our database, and a proposal is sent to the hospital.
The hospital rejects our proposal, and does not negotiate the charges. INSNET does not charge any fee because no discount can be applied. You will be responsible for paying the hospital the total amount due ($750). You receive a Transaction Summary detailing this via email.
Summary - Example 2
| $750.00 | Total cost of service |
| -$0.00 | Paid by insurance |
| $750.00 | Your responsibility |
| -$0.00 | Discount negotiated by INSNET |
| $750.00 | Amount paid to hospital |
| $0.00 | INSNET fee |