Frequently Asked
Questions
Patients often have inquiries about insurance documentation. We have compiled a list of the most commonly asked questions (FAQs) we receive. If you have any questions not covered here or need further information, please don't hesitate to reach out to us. You can contact us through our website or call us at (800) 961-6999.
Q1: What is an Explanation of Benefits (EOB)?
A1: An Explanation of Benefits (EOB) is a statement or document sent by your insurance company that explains how a claim was processed and the costs associated with the services you received.
Q2: When can I expect to receive my EOB?
A2: The timing of EOBs can vary depending on your insurance provider. Generally, you should receive an EOB within a few weeks after a claim is processed.
Q3: How can I access my EOB?
A3: Many insurance companies provide access to EOBs through their online portals. You can typically log in to your account and view or download your EOBs from there.
Q4: What information does an EOB contain?
A4: An EOB typically includes details such as the services or procedures performed, the healthcare provider's charges, the amount paid by the insurance company, any deductibles or copayments you owe, and any denied or not-covered services.
Q5: What should I do if I don't understand my EOB?
A5: If you have questions or find the EOB confusing, it's best to contact your insurance company's customer service department. They can explain the details, clarify any discrepancies, and address any concerns you may have.
Q6: Why are some services marked as "not covered" on my EOB?
A6: Services that are marked as "not covered" on your EOB may be excluded from your insurance plan or may not meet the criteria for coverage according to your plan's terms and conditions. Review your insurance policy or contact your insurance company for more information.
Q7: What should I do if I believe a claim was incorrectly denied on my EOB?
A7: If you believe a claim was incorrectly denied on your EOB, you can start by contacting your healthcare provider's billing department to discuss the denial. They can help review the claim and work with your insurance company to resolve any billing discrepancies.
Q8: Can I appeal a denied claim listed on my EOB?
A8: Yes, most insurance companies have an appeal process in place. If you disagree with a denied claim, you have the right to appeal and provide additional information or documentation to support your case. Contact your insurance company for specific instructions on how to initiate an appeal.
Q9: What should I do if my EOB shows that I owe more than I expected?
A9: If your EOB indicates that you owe more than you anticipated, review the details of the EOB and check if any deductibles, copayments, or coinsurance apply. If you still have questions or concerns, contact your insurance company to seek clarification and ensure the charges are accurate.
Q10: Can I use my EOB to verify if a claim has been paid?
A10: Yes, your EOB will provide information about the payments made by your insurance company toward your claim. It will show the amount paid and any remaining balance that may be your responsibility. Review your EOB carefully to verify if a claim has been paid and to understand your financial obligations.