Are you overpaying?
Learning about the billing process and the most common errors can help you feel more in control—and avoid overpaying.
- Once you leave the doctor’s office, a bill is triggered.
Your doctor charges your insurance company for the medical services you received. You may be sent a copy of that bill. If you do receive one, there’s no need to pay anything yet.
- Many insurance companies use the doctor’s bill to create your Explanation of Benefits (EOB) statement. This is 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 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
Clear your table and sit down with your bill. If you have an EOB, keep it handy and use it to double-check all the information on the bill.
Here’s what to look for:
- Spelling mistakes and inaccuracies. Check the spelling of your name and your physician’s name, dates of service, and whether your health insurance provider is up-to-date.
- A detailed list of services. You should see an itemized list of your medical services. Verify that you received every service on the list. If a detailed statement of services isn’t included (if you just see a total), call your doctor to request one.
- Common errors. In the list of services, check for double-charging for a single service. If you don’t recognize a service or if 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.
- Examine the “units” section. You may see “units” indicating how much of a given treatment (a medical procedure, drug or test) you received. If one looks high compared to the other numbers, verify it with your doctor’s office.
When your medical bill comes, take the time to review it. It’s your money, and you have a right to know where it’s going. Don’t be afraid to question charges or terms with your doctor’s office. Spending a few minutes to get familiar with your bill can save you money.