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Patient Statement

David Kim

ACC-10044 · UnitedHealth

Paid

Due July 5, 2025

Provider Note — Patient Confusion Hotspot

This is where most patient disputes originate. Use plain-language explanations below to prevent inbound calls. If insurance denied a line, make sure it is called out clearly.

What Was Billed

Annual Wellness Visit

Visit: Jun 1, 2025

$400.00

What Insurance Covered

Insurance paid (UnitedHealth)− $400.00

What You Owe

$0.00

Your insurance covered the full amount. No payment is required from you.

Patient-facing statement

The simplified version the patient sees on their phone.

View Patient View