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Reading Your Billing Statement

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This is an example of one our patient billing statements along with an explanation of what’s on it:

Example billing statement

  1. Code: This column contains either a medical code that corresponds with your treatment or a payment type code:


    PayCK:     Check payment
    PayCS: Cash payment
    PayVS: Visa payment
    PayAE: American Express payment
    PayMC: Mastercard payment
    PayIns: Insurance payment
    Pay835: Insurance payment
    InsAdj: Insurance adjustment
    AUTOAD: Insurance adjustment
    PayOT: Electronic payment plan

  2. Charges: The amount we charge for a particular treatment.
  3. Credits: Payments received or insurance adjustments.
  4. Pending: These claims are still being processed by the insurance company.
  5. Gray Box: This shows how long it has been since charges were entered. These balances include charges submitted to your insurance company.
  6. Amount Due: This is your balance and the amount you owe us at the time the statement was printed.

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I want to compliment you and your staff for the caring manner in which I was treated. You and your staff were genuinely concerned that I was comfortable and informed about the procedure I had. Each one of your staff members took the time to know my name, ask if I understood the medical procedure, explain what they were going to do and then answer any questions I had.

Betsy Crysel

Richland, Washington

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