Before You Pay Your Doctor Make Sure You Look at Your E.O.B.

Discussion in 'Black Health and Wellness' started by river, Oct 31, 2006.

  1. river

    river Watch Her Flow MEMBER

    United States
    Mar 22, 2004
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    Where the Niger meets the Nile
    +1,289 / -1
    My cousin is the accounts receivable manager at a cardiologist clinic and she told me some things few people know that could save them hundreds even thousands of dollars. An E.O.B. (Explanation of Benefits) is a document your medical insurance issues to you and your doctor whenever a file is claimed. What happens is when a ddoctor files a claim whether it is to Medicaid, Blueshiold or any insurance company the insurance company never pays them the full amount they ask for. The doctor may get one third or even one fourth what he asked for which is why they jack their prices up.

    What some doctors will do to recoup the rest of the money is to bill the patient for it. However if a doctor excepts any form of insurance he has a contract with that insurance company which requires him to accept whatever they pay and write the rest off. The E.O.B. will tell you what your responsibility is Sometimes you will be required to pay something but if your E.O.B. says you owe nothing then you don't owe him nothing. So before you pay anything out of pocket request an E. O.B.. If your doctor is trying to bill you illegally you can take that document to his office and show it to him.

    Also it is the doctor's responsibility, not yours, to make sure he has pre aproval on procedures which require it. If your insurance refuses to pay for something because the doctor did not get pre approval that is his tough luck. You are not required to pay.