Explanation of Benefits
Explanation of Benefits
I have never understood this document. It comes to me through the mail in a very official-looking envelope. The return address is my health insurance provider and it shows up after I’ve had a doctor’s appointment. A million things run through my mind like: maybe they’re writing to say I have a fatal illness. Or maybe they’re writing an “Oops! We accidentally covered too much of the bill at your last doctor’s appointment. Please remit payment for $598,340 at your earliest convenience.” This document scares me to death because written across it every-which-way are massive dollar amounts. Some are in parentheses, which might mean it’s a negative amount or it could mean the company is just having a little inside joke with me. Some dollar amounts are in bold, some are underlined, and some are italicized. My eyes dart back and forth across the pages and sweat forms on my brow. I need to sit down. I can’t pay this amount of money. What are they trying to do to me?
Then I see it. I see the disclosure. “This is not a bill.”
THEN WHAT IS IT? Is it just a little notice of bragging rights? “Look how much we did for you? Look at how much of your over-priced standard physical exam we covered for you!” Thanks, Mr. Health Insurance. Thanks for weakening my heart and expanding my ulcer and causing me to get on the phone with my doctor to set up another appointment to get these symptoms you just worsened checked out. I appreciate all of your hard work.
The EoB is a complete waste of paper. I hate those things. You should write them a letter giving them your own explanation of benefits. Maybe include a rotten sea bass in the envelope. That would do the trick, definitely.
rustafari
September 12, 2008 at 5:22 pm
They suck true and are totally hard to read. But it is the law that you receive one as well as your provider. The reason all those high dollar amounts appear is because your provider will have a fixed fee schedule if your insurance carrier does not have a contract with your provider. If there’s a contract in place that is why you see the high amount minus the contracted rate amount. Then you only owe the difference which is way less. But the fixed fee schedule set by your provider is legitimate and based on the usual and customary rate for you area.
Jason
September 12, 2008 at 5:54 pm