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This Web site contains a compilation of more than a thousand consumer finance  columns written by Tony Novak from the 1980s through 2006, updated and reformatted for maximum usefulness today.  New material was added after 2010.

Content is the opinion of the author and does not represent the position of any other person or entity. Information is from sources believed to be reliable but cannot be guaranteed.

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Payment procedure for medical treatment

originally posted: 11/22/2006  reposted: 2/18/2011 This post has not been recently reviewed or revised by the author and may be out of date. If you notice an error or are in doubt, please send a new question by email or ask for an update. Email

Q: I need to know how Simple STM insurance works. Do you pay the Doctor's / Hospital or Lab? Or do I pay and then get reimbursed?

A: Simple STM works the same way as all other commercial health insurance plans: the insurer pays you unless the provider provides a written authorization to pay the medical provider directly. This authorization is called an "Assignment of Claim" and is used by almost 100% of doctors and hospital in the U.S. for the processing of larger medical claims. For smaller medical bills (especially those less than your policy deductible) medical providers usually prefer to have you make the payment directly and then be reimbursed by the insurance company later. This is up to you and your doctor so you should discuss the doctor's billing procedure this before receiving treatment. Health insurance companies really have no preference as to who gets the payment, so this is completely under your control. You might want to read the article titled "Does My Doctor Accept this Insurance?" for a more complete discussion of this topic.


More resources:

"Does My Doctor Accept this Insurance?"