Understanding the billing process and the most common errors can help you avoid overpaying on your medical bills.
- After you visit with your doctor, a bill is issued.
- Your doctor will charge your health insurance company for the medical services you received. You may be sent a copy of that bill, but there’s no need to pay anything yet.
- Many insurance companies use the doctor’s bill to create your Explanation of Benefits (EOB) statement, not a bill. The EOB breaks down the services you received and notes what amount, if any, will be left for you to pay.
- Once your insurance company pays its portion, you will receive the actual bill from your doctor’s office. This bill shows all the medical services you received and the remaining balance for which you are responsible.
How to find errors on your bill
If you have an Explanation of Benefits (EOB), keep it nearby and use it to verify all the information on the bill. Here’s what to look for:
- Spelling mistakes and inaccuracies. Check the spelling of your name and your doctor’s name, dates of service, and whether your insurance provider is up-to-date.
- A specific list of services. You should see an itemized list of all your medical services. Confirm that you received every service on the list. If the bill doesn’t include an itemized list of all your services and you only see a total, call your doctor and request one.
- Common errors. In the list of services, check for repeated charges for a single service. If you don’t recognize a service or the wording is unclear, ask your doctor’s office. Each procedure should be identified by a standard CPT (Current Procedural Terminology) billing code, which is the same for every provider and facility.
- Check the “units” section. You may see “units” meaning how much of a given treatment you received, like a medical procedure, drug or test. If one looks high compared to the other numbers, verify it with your doctor’s office.
Once your medical statement arrives, take the time to review it. It’s your money, and you have a right to know where it’s going. If you encounter any errors on your bill, give Cosmo Insurance Agency a call, we have a claims department that will handle all this for you.
Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.