Deductible
The amount a patient pays out of pocket before their plan starts to share costs.
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A deductible is the amount a patient must pay for covered services before their health plan begins to pay its share. It generally resets each plan year, and services applied to the deductible are the patient’s responsibility based on the allowed amount.
Until the deductible is met, many services are paid entirely by the patient at the plan’s allowed rate, which is why verifying deductible status up front matters.
Why it matters for billing
Deductibles have grown, so more of a practice’s revenue now comes from patients rather than payers. Knowing where a patient stands against their deductible before the visit makes it possible to collect the right amount up front instead of chasing it later.
Related terms
Terms that come up alongside Deductible in the revenue cycle.
Billing that gets Deductible 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 reviewDeductible — frequently asked questions
It typically resets at the start of each plan year, so a patient’s remaining deductible changes over the year.
The patient, based on the plan’s allowed amount, until the deductible is satisfied.