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Patient Statement

Robert Tanaka

ACC-10045 · Medicare Advantage

Overdue

Due May 15, 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

Endocrinology Visit

Visit: Apr 5, 2025

$350.00

What Insurance Covered

Insurance paid (Medicare Advantage)− $125.00

What You Owe

$225.00

This is the remaining balance after your insurance paid their portion. This is your responsibility under your Medicare Advantage plan (deductible, copay, or coinsurance).

Patient-facing statement

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