Use this article to understand why the amount you were charged for a session may differ from your original cost estimate, Eligibility Check (EC).
Why Your Final Cost May Be Different
Before your session, Alma provides an estimated cost based on information received from your insurance company.
Your final cost is determined after your insurance company processes the claim. The amount you owe may change because your:
- Deductible status changed,
- The insurance company updated your benefits,
- Copay or coinsurance differs from the original estimate,
- Insurance coverage changed,
- The insurance company denied or adjusted the claim,
- Services billed affected how your insurance company processed the claim.
Review your Explanation of Benefits (EOB) to understand how your insurance company determined your responsibility.
Cost Estimates Are Not Final Bills
After your session, your provider submits a claim to your insurance company. Your insurance company processes the claim and makes the final decision about how much you owe.
Insurance claims typically take 45–60 days to process. Some insurance plans may also review or reprocess claims later.
Your estimated session cost is based on the insurance information available at the time of your eligibility check.
Your insurance company makes the final determination about:
- Whether a service is covered.
- How much your insurance plan pays.
- How much you owe.
If you believe your insurance eligibility or estimated cost is incorrect, you can Request a Review of Your Insurance Eligibility or Cost Estimate.
To understand the claim process, see: How Billing Works at Alma: From Claim to Invoice.
What Happens if Your Final Cost Changes?
If your insurance company determines that you owe a different amount than Alma originally estimated:
- Alma updates your invoice to match the finalized claim.
- If you paid too much, you'll automatically receive a refund for the difference.
- If you owe more than originally estimated, Alma will send an updated invoice for the remaining balance.
- If you're enrolled in Autopay, you'll receive 10 days' notice before any additional payment is processed.
Alma may also update your future cost estimates based on the finalized claim information.
I Met My Deductible. Why Do I Still Owe Money?
Meeting your deductible doesn't always mean your sessions are fully covered. Depending on your insurance plan, you may still owe:
- A copay
- Coinsurance
- Costs for services that aren't covered by your plan
Your Explanation of Benefits (EOB) explains how your insurance company calculated the amount you owe.
What Should I Do if I Have Questions?
Start by reviewing your insurance information, cost estimate or final invoice in the Client Portal.
If you need additional information about your coverage or benefits, contact your insurance carrier. For information on how to contact your insurance, see: Contacting Your Insurance Carrier
If you still need help, contact Alma by selecting the Help button in the bottom-right corner of the Support Center.