Does Your Medical Bill Look Like a Foreign Language? Here’s How to Make Sense of it.

November 28, 2016

Medical bills can sometimes seem like they’re written in a foreign language, but it’s important to understand the contents to avoid paying too much.

Insurance carriers have tried to ease your pain by providing an explanation of benefits (EOB); however, that can also be hard to decipher. Here are a few tips to make things easier.

Learn the process

When you visit the doctor or hospital or receive a medical service, that entity sends your insurance company a bill first. The insurance company takes a look at the bill, identifies the portion of the charges it owes, and then they send you the explanation of benefits. Simultaneously, your insurance carrier will also send you a bill for payment owed. You will usually receive the explanation of benefits first.

Comparing the two

Your medical bill could contain simple errors, like a name misspelling, that will cause your insurance carrier to reject your claim. A simple billing error not caught could mean having to pay more than you really owe.

To discover billing errors, here’s what you need to do:

  • When you open the bill, make sure it’s itemized. Don’t pay a bill that shows a lump sum payment due. You should be able to review each item that you’re being billed for so you can compare the services to the explanation of benefits.
  • Check that the information on the bill is correct, such as your name, address and date of service.
  • With the itemized bill in hand, start comparing each charge against the codes on the EOB.
  • Look for errors. Review the charges that the insurance isn’t paying. Look for charges for services you didn’t receive. Do you see marked similarities between the charges the carrier has paid and the charges you still owe? For example, it’s common for a carrier to bundle charges together, but it’s also a common error to charge for services in a bundled fashion, and then also list each of the bundled services as separate charges. It’s your job to identify this kind of error.

If you don’t find any errors, pay the bill.

If you’re unsure about the bill, get help. You can always ask the doctor’s office or hospital for help understanding your bill and the changes, or work with an advocate.

Nonprofit organizations exist to help individuals figure out their medical bills, or you could ask a friend or family member to help you work through the bill. It’s also possible to hire a professional health advocate.

Make sure you understand your medical bill and don’t pay it until you’ve worked through every line item and are confident it’s accurate. If you’re taking your time to review the bill, be sure to call the insurance company or service provider to let them know you are working things out and in order to avoid late fee charges.

Your independent agent at UROne Benefits™ will assist you with any billing errors. Contact us today to become a client. 800-722-7331.