Healthcare billing can be complex, and patients may feel overwhelmed by the myriad of numbers and codes on their Explanation of Benefits (EOB) statements. However, regularly reviewing your EOBs is crucial for avoiding unexpected costs and identifying potential discrepancies in your medical billing. In this blog post, we’ll explain what an EOB is, why it’s essential to check it frequently, and how to spot any errors to ensure you’re not paying more than you should for your healthcare services.

Understanding Your Explanation of Benefits (EOB)

An EOB is a statement you receive from your health insurance provider after you’ve received medical services. It is not a bill, nor a medical bill, nor a health insurance bill, but rather, an EOB is summary of the healthcare services you’ve received, the amount billed by your healthcare provider, the amount covered by your insurance, and any out-of-pocket costs you’re responsible for, such as deductibles, co-payments, and co-insurance.

Why Checking Your EOBs Matters

Regularly reviewing your EOBs is essential for several reasons:

• Confirm accuracy: By checking your EOBs, you can verify that the services listed are ones you’ve actually received and ensure the billing codes are correct.
• Understand your out-of-pocket costs: Your EOB will help you keep track of your deductible, co-payments, and co-insurance, allowing you to budget for future healthcare expenses more accurately.
• Spot billing errors: Identifying and addressing any discrepancies in your EOB can help prevent overpaying for services or paying for services not rendered.

How to Check Your EOBs

What to check and how to review your Explanation of Benefits:

• Review the services listed: Ensure that the services and dates of service listed on your EOB match your records and medical appointments.
• Verify your financial responsibility: Compare the amounts billed, the amounts covered by your insurance, and the remaining balance to ensure the figures align with your understanding of your insurance coverage.
• Monitor your deductible, co-payments, and co-insurance: Keep track of these amounts to ensure you’re not being overcharged and that you’re aware of your out-of-pocket expenses.

Addressing Discrepancies

If the Explanation of Benefits is wrong or you spot a discrepancy or potential error on your EOB: 

• Contact your healthcare provider: Discuss the discrepancy with your healthcare provider to determine whether it’s an error or if there’s a valid explanation for the charge.
• Reach out to your insurance company: If the discrepancy is related to your insurance coverage, contact your insurance provider to address the issue.
• Keep records: Maintain a file with your EOBs, medical bills, and any correspondence related to billing discrepancies to help you track and resolve issues.

Tips for Staying Organized

Staying organized can make reviewing your medical bills and EOBs more manageable:

• Create a designated folder or digital file for your EOBs and medical bills.
• Set aside time each month to review your EOBs.
• Use a spreadsheet or app to track your healthcare expenses and out-of-pocket costs.

Checking your EOBs frequently is an essential practice to avoid unexpected costs and discrepancies in your healthcare billing. By staying organized, verifying the accuracy of the information, and addressing any discrepancies, you can protect yourself from overpaying for your healthcare services and ensure you’re well-informed about your medical expenses.

Contact Us

Soultenders can help you find a therapist in your insurance network. Soultenders’ goal is to reduce the amount of administrative work therapists need to do so that they can focus all their energy on helping their patients. If you have any questions or if you would like more information, please reach out and contact us.