A Brief Overview in Understanding Health Insurance Bills

A good amount of Americans have at least some knowledge of how health insurance bills work. Baby boomers are able to make their own decisions on health care and have experience from previous situations to help make the best decision. Although they have experience, only about 40% of boomers understand insurance fully. According to studies done on millennials, more than half of millennials have little to no understanding of out-of-pocket health costs. Another statistic shows that around 74% of millennials fail to pay medical insurance bills in full on time. So how can we help millennials understand how insurance bills work? Today, I’m going to go over how the billing cycle works so those reading can have a better understanding of health bills.

Understanding Your Insurance Bill

When you receive a bill from your healthcare provider, you will hear some new jargon, such as co-pays, deductibles, etc. It can be confusing, and it’s important to know what the health insurance lingo means. For example, your total charges are the total amount you will be charged before your insurance kicks in. Billed charges are the total amount charged directly to you or your insurance. Insurance payments are the amount of money your provider has paid. Patient payments are the amount you will be responsible to pay. The adjustment on your bill is the amount the healthcare provider has agreed not to charge.

Understand your EOB

When it comes to your benefits, you can always request an explanation of benefits (EOB) form from your insurance company. An explanation of benefits is sent by your insurance and explains what medical treatments and/or services were paid for on their behalf. This can help you understand the impact your health insurance plan has on the cost of your medical services. You might see some columns titled total amount, one that says not covered, and covered by plan. Each has its own significance. For instance, the “total amount” is the total cost of procedures, surgeries etc. Your “not covered amount” is what you will be coming out of pocket, due to the insurance not covering it.

Look for errors

Be sure to check your bill for any errors. Compare estimates to final cost to make sure everything that was supposed to be covered is covered. Also, know what you’re being charged for so you will not be shocked by anything that may pop up on your bill. Upcoding could happen which is reporting incorrect diagnosis in order to profit. If you see this, you will need to contact your healthcare providers billing office.

Since insurance is often times overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  So if you have any questions or concerns, comment below and your question may be the topic of our next video!

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