Patient Statement
Carlos Rivera
ACC-10047 · Humana
Sent
Due July 10, 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
Physical Therapy Eval
Visit: Jun 5, 2025
$375.00
What Insurance Covered
Insurance paid (Humana)− $220.00
What You Owe
$155.00
This is the remaining balance after your insurance paid their portion. This is your responsibility under your Humana plan (deductible, copay, or coinsurance).
Patient-facing statement
The simplified version the patient sees on their phone.