My Coverage Explained
Even a simple visit to the doctor's office may result in two or more Explanation of Benefits (EOB) statements, depending on what services you received from other providers.
Let’s take a routine doctor visit to check your cholesterol as an example. You go in to the office and while you’re there, you mention the pain you’ve had in your arm since you fell last week. The doctor draws blood for the cholesterol check and takes a few X-rays of your arm. It’s one visit, but you just had two procedures. While your blood is sent to the lab for the cholesterol check, a radiologist reviews your X-rays. The reports from both procedures are then sent back to your doctor. In this situation you can expect at least three different providers billing claims for that one doctor's visit, because each provider bills separately. When it comes to inpatient and outpatient hospital services, there are even more services involved. In those situations, you’ll get multiple EOBs from different providers, depending on the services you received during your hospital stay. The physician charges will always be billed separately from all hospital charges.When you receive your EOB, don’t just give it a once-over. Read through it carefully to make sure the services you received match the services listed. It will also outline how much your health insurance plan covered for these services. If you have any questions, you can always call us at the number on the back of your Member ID card or ask your doctor about the service. Go green and sign up for a paperless EOB!
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