This Simple Form Can Keep You From Overpaying For Medical Care
- Mistakes in medical billing include improper coding or incorrect insurance benefits being applied to a claim.
- Even if the explanation of benefits looks accurate, it should be compared with bills you receive from a doctor or other provider to make sure they match up.
- If you see a mistake, start by calling your insurer.
You know that “explanation of benefits” form you get from your insurance company? Resist the urge to toss it in the trash.
Even if it looks like a bewildering mess of numbers, codes and abbreviations, there’s a good reason to learn how to make sense of it.
Basically, this EOB, as it’s known, could be what keeps you from overpaying for your medical care.
“You have to make sure the EOB is right and compare it with the bill from your provider to make sure they match, because they don’t always,” said Mitch Rothschild, founder and chairman of consumer health-care site Vitals.com.
As health-care costs continue climbing and patients take on a larger share of those expenses, containing the effect on your budget is worth it.
Annual premiums for employer-sponsored family coverage reached $18,764 in 2017, with workers paying an average $5,714 out of pocket, according to the Kaiser Family Foundation.
That amount does not include what you might spend to actually go to a doctor. Depending on the specifics of the care you receive and your insurance coverage, using the health-care system could add hundreds or thousands of dollars to your annual outlay.
Insurers are required by law to send you an EOB every time your doctor or other provider files a claim for treating you. As its name implies, the form’s intent is to show you what your insurance plan is covering for care you’ve received.
Yet mistakes happen in the medical billing process. Exactly how often, however, is hard to come by.
While research from the American Medical Association showed that 7.1 percent of all claims paid by insurers in 2013 contained a mistake, patient advocates and other professionals who review medical claims for accuracy put the frequency of billing errors at more like 80 percent or even 90 percent.
“You’d be shocked by how often mistakes are made,” said Missy Conley, director of consumer claims for Medliminal.com, which reviews medical bills on behalf of clients.