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Open Discussion Discuss The importance of checking those EOBs at the General Forum; I believe I may have noted previously the huge importance of checking one's EOBs (Explanations of Benefits) before paying a ...

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Old 07-30-2011, 04:46 PM
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Default The importance of checking those EOBs

I believe I may have noted previously the huge importance of checking one's EOBs (Explanations of Benefits) before paying a medical bill. And we just stumbled upon an excellent example of this.

Just today, we received in the mail a bill in the amount of $138.26 for services rendered on 5/19/11. This is for Submitted Charges in the amount of $244.00.

And that amount, for the Submitted Charges on that date, is correct.

But the attending doctor is a Preferred provider (i.e. is in-network with BC/BS); so the (quite predictable) insurance adjustment applies. That adjustment is in the amount of $117.06, thereby bringing down the Plan Allowance to a mere $126.94--not $244.00.

The billing statement we received does not reflect this insurance write-off.

Moreover, it shows $105.74 paid by BC/BS; whereas the EOB shows slightly more paid, at $107.90.

But the bigger error, by far, is the failure of someone to credit the insurance adjustment of $117.06.

Garbage in, garbage out, as the old saying goes.

I will attend to this matter Monday, and get it corrected...
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