Coinsurance
The patient’s percentage share of the allowed amount after the deductible.
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Coinsurance is the share of a service’s cost a patient pays as a percentage, typically after the deductible is met. It is calculated from the allowed amount, so the dollar figure changes with the price of the service.
Because it depends on the allowed amount and the deductible status, coinsurance is often easier to estimate than to know exactly at the time of service.
Why it matters for billing
Coinsurance is a growing part of patient responsibility and harder to collect after the fact. Estimating it from the allowed amount and the patient’s benefits helps set expectations and collect a fair share earlier in the cycle.
Related terms
Terms that come up alongside Coinsurance in the revenue cycle.
Billing that gets Coinsurance right
EnVisionMD RCM handles eligibility, coding, documentation, denials and follow-up end to end — so the details behind terms like this one are managed for you, not left to chance.
Request a free billing reviewCoinsurance — frequently asked questions
As a percentage of the allowed amount, generally after the patient’s deductible has been met.
Because it depends on the allowed amount and deductible status, the exact figure may not be known until the claim is processed, so it is often estimated.