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How will I know when my client has met their deductible and/or out of pocket max?

To know when a client has met their deductible and/or out of pocket max, the CLIENT MUST NOTIFY YOU that they believe their deductible or out of pocket max has been hit. To re-verify this with CCS, submit a benefit verification request and select "existing client to reverify".

Staying Ahead of Billing Changes - Since insurance data isn't always real-time, monitoring the transition from "Deductible" to "Copay" (or $0 cost-share) requires a proactive approach. Use this simple checklist to avoid over-collecting from your clients:

  • Routine Check-ins: Ask clients with high-deductible plans if they’ve had recent specialist visits or procedures.

  • Monitor Payment Reports: Check the "Copay/Deductible" column on bi-weekly payment reports for any amount changes.

  • Watch for EOBs: If a client receives an Explanation of Benefits (EOB) showing their deductible is met, have them share a copy with you.