Not sure how to read parts of your bill? Use the following sample bill to help you understand your latest statement. Learn more about billing and insurance.
Your Statement
- Patient’s Name/Guarantor – The person legally responsible for paying the bill.
- Guarantor Account Number – Your financial account number with UT Southwestern. Please use this number as a reference if you contact us with questions.
- Charges – The total charged by UT Southwestern for the patient’s health care services.
- Adjustments and Payments – Credits to your account for payments already made by you or your insurance company (such as copays or coinsurance). This also includes any contractual adjustments given by your insurance company and any discounts made to your account.
- Patient Outstanding Balance – The total amount you (the Guarantor) owe to UT Southwestern.
- Payment Due Now – The portion of your total balance you (the Guarantor) owe this month.
- Payment Options – Pay your bill online through MyChart, over the phone with a credit or debit card, or by mail with a credit or debit card or personal check.
- Payment Plan Information – If you are paying your balance on an installment plan, the plan is summarized here.
- Service Details – The services provided by UT Southwestern and the charges, adjustments, discounts, and payments for each. Each service entry includes:
- Location of the service and date range of the billing transaction for that service
- Service provided
- Any adjustments, discounts, or payments made by your insurance company
- Payments made by you (the Guarantor), including any copay, coinsurance, or deductible payment(s)
- Your responsibility – The amount owed for that specific service. (Note: This is not your total balance due.)
- Statement Totals – The total of each service column, including total charges (shown as 3 on the first page), total payments and adjustments (shown as 4 on the first page), and total patient balance (shown as 5 on the first page).
