They start with by asking your health insurance company and then get the policy number which is located on your card. Then they essentially confirm with the health insurance company that you are still active in that specific plan. If confirmed, you will be charged just for the copay, aka the office visit fee. If denied, you’ll have to pay by cash, credit, or check but the health insurance company can reimburse you later if it was a mess up.
Ideally it’s all automated and they just type your number in a system like a United Healthcare card and tells you how much they cover.
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