How do deductible and coinsurance work in hospital billing, and how does Resolute apply them?

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In hospital billing, patient responsibility is split into deductible and coinsurance. The deductible is the amount the patient must pay out-of-pocket before the insurance starts contributing. After the deductible is met, coinsurance is the patient’s share of the costs—usually a fixed percentage of the allowed charges—until the plan’s out-of-pocket maximum is reached. Resolute applies them by first determining how much of the deductible remains on the patient’s plan and applying charges toward that amount until it’s satisfied. Once the deductible is met, Resolute calculates the coinsurance portion of the remaining allowed charges and posts that amount to the patient’s balance, while the insurer pays its negotiated portion. The system continues to post insurer payments and patient responsibility as the claim progresses, ensuring the patient’s liability is accurately tracked and updated.