Frequently Asked Questions
About Certainly
What is Certainly Health?
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Certainly Health is a healthcare marketplace for insured patients.
We predict and guarantee the out-of-pocket cost of common medical services across as many providers as possible.
Patients can compare prices and be fully confident that whatever prices they see upfront is all they'll ever owe when they pay with
We predict and guarantee the out-of-pocket cost of common medical services across as many providers as possible.
Patients can compare prices and be fully confident that whatever prices they see upfront is all they'll ever owe when they pay with
Why do I need Certainly?
Americans on high deductible health plans (HDHP) must pay for most of the cost of care until their out-of-pocket max is met. But there's no upfront visibility into how much different treatments cost or how that cost could differ by going to different providers.
Prices are negotiated between insurance companies and health providers. These negotiations lead to the cost of the same service varying by as much as 10x across providers, with no correlation to quality.
Certainly Health creates price transparency for you to compare and choose the best provider for you while knowing the exact cost to visit each provider.
Prices are negotiated between insurance companies and health providers. These negotiations lead to the cost of the same service varying by as much as 10x across providers, with no correlation to quality.
Certainly Health creates price transparency for you to compare and choose the best provider for you while knowing the exact cost to visit each provider.
How is Certainly Health different from other websites that list prices?
Other websites only show estimates or broad price ranges because it's difficult to calculate and guarantee the out-of-pocket cost for an insured patient across all providers.
We have processed terabytes of data to provide a patient-specific predicted price for the most common medical services for as many providers as possible. We guarantee those predictions with Certainly Price Protection to enable consumers to book care upfront with confidence.
We have processed terabytes of data to provide a patient-specific predicted price for the most common medical services for as many providers as possible. We guarantee those predictions with Certainly Price Protection to enable consumers to book care upfront with confidence.
How does Certainly Health work?
- Search for providers nearby and compare out-of-pocket costs across providers.
- Choose a provider with Certainly Price Protection. We can book the appointment for you (free of charge), or you can book it yourself.
- A few days after you see the provider, we'll charge your card for the cost of services done during the visit and take care of paying the provider.
- If your insurance company sends an Explanation of Benefits (EOB) that says you owe a different amount from the prices in the Certainly Price Protection package:
- Email a PDF or photo of the EOB to support@certainlyhealth.com
- If you owe more, we will pay the provider the difference.
- If you owe less, we will refund you within 24 hours.
What is Certainly Price Protection?
All Certainly Health prices are predictions based on your specific insurance and negotiated rates data.
Certainly Price Protection is a guarantee you will not pay any more than the predicted price for the specified medical services.
If your insurance company sends an Explanation of Benefits (EOB) that says you owe more than the prices in the Certainly Price Protection package, we will pay the provider the difference. If you owe less, we will refund you within 24 hours.
Certainly Price Protection is a guarantee you will not pay any more than the predicted price for the specified medical services.
If your insurance company sends an Explanation of Benefits (EOB) that says you owe more than the prices in the Certainly Price Protection package, we will pay the provider the difference. If you owe less, we will refund you within 24 hours.
How does Certainly Price Protection work?
Suppose you book a dermatologist with a Certainly Price Protection package where the office visit is $100 and a skin biopsy is $500
Several weeks after your appointment, your insurance company sends you an Explanation of Benefits (EOB) that determines how much you owe:
- If you owe $150 for the office visit fee, we will pay the provider the remaining $50 for you.
- If you owe $90 for the office visit. fee, we will immediately refund you $10.
- Similarly, if you get a skin biopsy during your visit, we will charge you for $500 after your appointment, and cover the difference or refund you as needed.
However, you suppose you do a laser treatment that was not mentioned in the Certainly Price Protection package. If your insurance EOB says the laser treatment costs $75, you'll have to pay $75 to the provider.
Which medical services and procedures does Certainly guarantee?
The prices are only guaranteed for the listed services that appear in search results. If there are procedures not listed that you would like to see, email support@certainlyhealth.com and we'll add them as soon as possible.
Prices
Why would my actual treatment and cost differ from the prices I see?
Upon evaluating your specific condition, the provider may do more or fewer services that could change the final cost.
The predicted total shown is for services often done during visits with the selected reason.
The predicted total shown is for services often done during visits with the selected reason.
Why can't I just pay the provider directly?
Certainly Price Protection ensures the predicted price is all you will ever pay for the specified services. Without it, the price is not backed by providers. Providers are often unable to offer upfront prices and may be unaware of Certainly Health.
What do prices that say "up to $..." mean?
Prices with "up to $..." are estimates of the maximum amount you may be billed by a provider if you don't pay through Certainly Health. Unpredictable insurance eligibility rules can lead to wide variances in each patient's out-of-pocket cost (e.g. if a patient ends up being out-of-network). Paying with Certainly Price Protection ensures you will see exact, guaranteed prices for the services listed under a provider.
How do payments work between Certainly, insurance, and the provider?
Your card will not be charged until as early as two days after your appointment.
The provider will bill your insurance as usual, and you will still receive an Explanation of Benefits (EOB) from your insurance company.
The only difference is we will pay the provider for you so you'll never get a bill from the provider for any of the services listed in your Certainly Price Protection package.
If the provider performs any services not listed in your Certainly Price Protection package, you will be liable and have to directly pay the provider for those services.
The provider will bill your insurance as usual, and you will still receive an Explanation of Benefits (EOB) from your insurance company.
The only difference is we will pay the provider for you so you'll never get a bill from the provider for any of the services listed in your Certainly Price Protection package.
If the provider performs any services not listed in your Certainly Price Protection package, you will be liable and have to directly pay the provider for those services.
How do refunds work?
If you receive an Explanation of Benefits (EOB) from your insurance company with a patient responsibility less than what you paid upfront, just email a PDF or photo of the EOB to support@certainlyhealth.com, and we will refund you the difference within 24 hours.
What is the cancellation/rescheduling policy?
If you cancel your appointment or don't see this provider for any reason, we will not charge you. You can cancel or reschedule your appointment by directly calling the provider. Or you can email us at support@certainlyhealth.com to do so on your behalf.
Insurance
Will costs incurred during my visit count towards my deductible?
Yes. All billing will go through your insurance just like any other visit.
Which insurances does Certainly support?
Currently, our platform only supports patients with the listed insurance plans when searching, though we are working to add all insurance plans. Contact support@certainlyhealth.com to request we prioritize your insurance plan. Unfortunately, we are not able to support uninsured, Medicare, or Medicaid patients at this time.
About us
Who's behind Certainly Health?
Kevin is Certainly Health’s CEO and cofounder. After graduating from Stanford, he worked at Uber where he was a founding member of the Uber Health team.
Daryl is Certainly Health's CTO and cofounder. After graduating from Cornell, he built augmented reality games at Snapchat, built autonomous cars at Xiaopeng Motors, then started a food delivery marketplace.
Daryl is Certainly Health's CTO and cofounder. After graduating from Cornell, he built augmented reality games at Snapchat, built autonomous cars at Xiaopeng Motors, then started a food delivery marketplace.
