Why might Cardiogram file a health insurance claim?


Cardiogram is a registered healthcare provider. Similar to a doctor's office, we are paid by your health insurance. We know it's not common for an app to bill your health insurance, but hopefully this page helps explains why we do, and what that means for you.

What service is Cardiogram filing a health insurance claim for?

As part of Cardiogram Care (What is Cardiogram Care?), Cardiogram offers free at-home and in-lab testing to users. If you complete a test and the result is abnormal (e.g. elevated blood pressure), Cardiogram files a claim with your health insurance for the test that we sent. Note: Cardiogram does not file a claim if the results of the test are normal. We will only request payment from your insurance if we helped you learn something new about your health.

Will I be billed out-of-pocket?

No. Cardiogram will only file a claim if (a) your health insurance plan has out-of-network coverage and you have met your out-of-network deductible, or (b) your health insurance fully covers Cardiogram Care.

I received something that looks like a bill from my insurer. What is it? 

That is an explanation of benefits (EOB). It looks like a bill, sounds like a bill, but it's not a bill. In fact, in the upper right or left of the letter, you may see the explicit phrase, "THIS IS NOT A BILL". 

An EOB is sent after your health insurer processes a claim filed under your name. It explains what portion of the claim was paid by your insurer and what portion you might have to pay. If you receive an EOB that mentions a claim filed by Cardiogram, you do not owe any money to your health insurer or to Cardiogram. The EOB is simply explaining that your insurer paid Cardiogram. Here's an example EOB from Blue Cross Blue Shield with explanations on what each section means (your EOB may not look exactly the same, but the sections are likely similar):

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