Omada Joint and Muscle Health Program Billing Frequently Asked Questions

Get answers to frequently asked questions about billing for your Omada Joint and Muscle Health program below.

1. Why was my insurance charged?
   • Omada partners with employers and health plans to provide you with our healthcare services. Just like a doctor’s office, Omada submits medical claims for payment for your participation in the program. 
2. What was my insurance charged?
   • The claim was filed as part of Omada’s agreement with your health plan. Our billing is based on your interactive video Consultation with one of our Physical Therapists, and opting into the Recovery Phase guided by a Physical Therapist. Additional specifics are unique to each health plan.
3. What is an EOB?
   • EOB stands for an Explanation of Benefits. This is a statement sent by your health plan explaining what services were paid for on your behalf. An EOB is not a bill; it is simply a receipt of the medical services you received.
4. Why did I receive an EOB from my insurance?
   • An EOB is generated when your health plan processes and pays a claim on your behalf; think of an EOB as a receipt from your health plan. This is completely normal and simply to let you know that your health plan has made payments to cover your health care costs - in this case your participation in the Omada program. It is not a bill.
5. Why is my insurance requesting other insurance information?
   • Your health plan is trying to identify if another payer should be responsible for the charges for Omada. Please complete and submit any paperwork received from your plan. The Omada billing team will take care of any additional steps needed to ensure outstanding claims have been processed. 
6. How will I know if I owe a balance to Omada?
   • If you owe a copay, coinsurance, or deductible amount, you will receive an email from Omada with a link to a secure third-party payment provider site to pay your bill. (Details below)
7. If my insurance shows I owe something, what should I do?
   • If an EOB shows that there is a copay, coinsurance, or deductible amount owed, please note that Omada’s billing team will review this information to ensure your portion was calculated correctly. If an amount was assigned in error, Omada’s claims team will reach out to your health plan to request the claim be reprocessed and paid in full. You will receive an updated EOB once the claim has been reprocessed, or you may check your patient portal. Please note this can take up to 90 days. If an amount was assigned correctly, you will receive an email from Omada with a link to pay your bill. Payments can be made online or via check. No credit card information is stored by Omada; we use Stripe, a third-party payment provider that adheres to industry data security standards to ensure your financial information is transmitted and handled securely.
8. I'm paying out of pocket. What payment methods does Omada accept?

• If you are paying out-of-pocket for Omada's services, we accept credit cards or debit cards. A secure link is used to access and pay your invoice.