After you visit a provider, you may get a bill telling you how much you have to pay.
After you get care, your provider sends a bill, or “claim,” to your insurance company. Your insurance company handles the claim and sends you an Explanation of Benefits (EOB).
Doctors and insurers use standard codes for each medical service or supply. That helps them communicate about treatments and payments clearly.
Medical supplies and equipment, such as bandages and wheelchairs, and ambulance rides are often listed separately on bills and Explanation of Benefits (EOB) forms.
When Out-of-Network Care Can Be Covered in Network
Flexible Spending Plans
Appealing a Reimbursement Decision
Choosing Your Healthcare Provider In-Network and Out-of-Network Care
Every medical service has its own special code number called a CPT® code. Knowing that code number helps you get the most accurate cost estimate and understand your bill.
After you visit the doctor, your plan may send you an “Explanation of Benefits”, or EOB, explaining how much they paid and why. If you owe any money, you´ll get a bill directly from your provider.
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Insurance Basics: Understanding Your Bill
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