With ample opportunities for billing errors within today’s complex health care claims and reimbursements systems, it’s a wonder people carrying individual medical insurance don’t spend more time carefully checking each Explanation of Benefit (EOB). The EOB shows what was charged less what the insurer agreed to cover, the balance being what you owe. Checking your EOB is the first line of defense against overpaying on a health insurance claim.Your EOB may not reveal a lot, but you can check to see that your name, address, and policy information are correct. You should also confirm that you were charged the “allowable” rate set by your insurer and not a penny more. Deductibles can be as high as $10,000, and payment comes entirely from your bank account, which makes group discounts all the more important.Other common errors the EOB may reveal include: Failing to get credit for a deductible that has been paid, in-network providers classified as out-of-network, legitimate claims denied as “medically unnecessary,” “upcoding” (being charged for more expensive services than you received), and “unbundling” (when a single procedure is broken down and billed as many). At Blue Cross/Blue Shield’s Web site www.bcbs.com/betterknowledge/anti-fraud/explanation-of-benefits.html, there’s a brief tutorial on how to read […]
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