How do I understand my bill and pricing?

After any medical service, you will receive an Explanation of Benefits (EOB) in the mail. The statement  is a breakdown of what medical treatments were billed and what benefits were paid, along with indicating what you, the patient, is responsible for.

A balance bill is when a provider bills a member for the difference between what the health insurance allows for a medical service versus what the provider chooses to charge. In essence, it’s when the provider charges more than what the Explanation of Benefit (EOB) indicates is patient responsibility. Example: Your hospital charges are $100 and the plan allowable at 150% of Medicare is $70.00. If the facility provider bills you the $30 difference between the charged amount and the Plan allowable, they are balance billing. Deductibles, copays, and coinsurance are not examples of balance billing and you are still responsible for these cost sharing items.