Benefits & Coverage Viewer
Eligibility · Provider + Patient ViewsReal-time coverage picture for every patient, at every workflow gate. Providers see effective dates, plan history, and billing balance at a glance. Patients see a receipt-style tracker showing exactly where they stand on deductibles, copays, and what insurance pays them.
Current coverage — Dave Kowalski
👣 Primary — UnitedHealthcare Choice Plus
Member ID9AA1-BB2-CC3
Group #GRP-44782-MKE
EffectiveJan 1, 2026 — active
Plan typePPO · In-network + out-of-network
PCP requiredNo (PPO)
Referral requiredNo (PPO)
👣 Secondary — Medicare Part D (fallback)
MBI1EG4-TE5-MK6
EffectiveMar 1, 2024 — active
CoverageRx only — formulary tier 1–3
CoordinationUHC primary pays first; Part D covers Rx gap
Coverage effective-date history
Jan 1, 2026 — present
UnitedHealthcare Choice Plus (PPO)
Employer group · sponsored by Trek Bicycle Corp. Open enrollment. Deductible reset: $1,500 individual.
Jan 1, 2025 — Dec 31, 2025
UnitedHealthcare Choice Plus (PPO)
Prior year. Deductible $1,500 — met Oct 12. Total paid by plan: $8,240.
Jun 1, 2023 — Dec 31, 2024
Anthem Blue Cross Blue Shield (HMO)
Terminated — employer switched carriers. Required PCP referral for all specialists.
Mar 1, 2021 — May 31, 2023
Molina Healthcare (Medicaid)
Coverage during unemployment period. $0 copay. Terminated when income exceeded threshold.
Account balance & billing summary
$1,500
Annual deductible
$890
Met to date
$610
Remaining deductible
$45
Patient balance owed
💰 Billing history — 2026 YTD
| Date | Description | Billed | Insurance | Patient | Status |
|---|---|---|---|---|---|
| Jan 15 | Annual wellness (99396) | $280 | $280 | $0 | Paid |
| Feb 8 | Sick visit — sinusitis (99213) | $140 | $105 | $35 | Paid |
| Mar 3 | Lab — CMP + Lipids | $85 | $63 | $22 | Paid |
| Apr 12 | Follow-up GI (99214) | $195 | $146 | $49 | Pending |
| May 21 | Sick visit — H. pylori (99213) | $140 | — | — | Pending |
See also: Eligibility Exec view · RCM / Billing · Care Plan Gallery · Booking Flow