Understanding Your Walkout Statement

The walkout and billing statements are almost identical. And contain most of the same information.

During this explanation it will be necessary to scroll, from left to right and from top to bottom on the screen to the right to view the different parts of the statement as it is discussed in this window. The example is for a factious patient.

At the top on the left hand side of the statement you will see the office address and contact information. Below this is your address. On the top right hand side you will find your account number and the date the statement was printed. The next block down on the page contains treatment information for your visit to our office.

This block consists of seven columns. The first column is the name of the family member treated. Column two is the ADA code for the treatment received and column three is a description of this treatment. Column four and five provide information on which tooth, arch or surface was treated. Column six is the fee charged for treatment and column seven is the amount of the fee estimated to be covered by your insurance. In our example line item eight is how payment on the account will appear. Line item nine is a filling on the distal and occlusal surfaces of tooth 29. Below this block is the summary block.

The summary block is divided into six columns. The first column is the total of fees prior to today. The second column is the total of today's fees. Column three is the amount of any payment make today. Column four is the sum of columns one and two minus the amount in column three. The fifth column it the total amount estimated to be paid for by insurance. The last column, six, is column four minus column five, if five is greater than four otherwise column six is zero.

The next block is your families future appointments. This block is divided into five columns. The first four columns are self explanatory. The fifth column describes the type of treatment that is schedule for the appointment as well as any estimated co-payment for this appointment.

The final block is for comment,. such as post or pre treatment requirements.

If you have any further question call us at (630) 420-0013 or email us.