Home » How to Read Your Medical Bills and Explanation of Benefits
Medical bills are becoming increasingly complex and difficult to read. Charges from clinics and hospitals are often lumped together rather than itemized, making it very difficult to see exactly what you are paying for. Here are some common elements and details you’ll find on a medical bill:
1
Patient and provider information— The names of the patient and the health care provider
2
Guarantor— The person financially responsible for the bill, such as the patient or guardian
3
Date(s) of service— The date when the care happened
4
Account or statement number— The unique identifier for this bill
5
Description of services— The care received, such as office visits, labs, procedures or medications
6
CPT codes— Standard medical billing codes that describe services provided and are used by insurance to determine coverage
7
Charge amount— The provider’s original price for each service, also called the “billed charge”
8
Adjustments— Discounts negotiated between the provider and insurance
9
Insurance payments— The amount that insurance has already paid toward each service
10
Deductible applied— The portion that applies to the annual deductible
11
Copay or coinsurance— The share of the cost after insurance
12
Balance due— The final patient responsibility after insurance payments and adjustments
13
Due date and payment options— Lists how and when to pay, often including payment plans or assistance options
Take charge of your health care dollars by reviewing your medical bills to spot any mistakes. Reach out to the health care provider’s billing office if you have any questions or want to negotiate.
