Reimbursement is the money returned to you after your claim is approved. When you pay for medical services out-of-pocket and submit a claim, reimbursement is the payment you receive back for eligible expenses covered under your benefits plan.
Reimbursement is common in "pay-and-claim" models where employees pay upfront at the clinic and then submit claims afterward. The reimbursement amount typically equals the covered portion of your expense, minus any co-payments, deductibles, or amounts that exceed your annual limits. Processing time varies by provider but typically ranges from 5-15 business days after claim approval. Reimbursement is usually sent via direct deposit, payroll adjustment, or check, depending on how your company has set up the system.
How reimbursement works in Soda
Soda makes reimbursement fast and straightforward:
When reimbursement applies:
- Non-panel clinic visits: E.g. If you're on Soda Plus and visit a clinic outside Soda's panel network, you (employee) pay upfront and then get reimbursed
- Flex benefits claims: When you submit claims for flexible benefits expenses (gym memberships, courses, etc.)
When reimbursement doesn't apply:
- Panel clinic visits: These are cashless - you don't pay anything upfront, so there's nothing to reimburse. Soda bills your company directly.