BILLING FAQ
EXPLANATION OF BENEFITS
What is an Explanation of Benefits (EOB)?
An Explanation of Benefits, commonly referred to as an EOB, is a statement provided by your health insurance company after you receive medical services. It outlines the details of the services you received, the amount billed by your healthcare provider – Rume Medical Group- what your insurance covers, and what you may be responsible for paying out of pocket. It is important to note that an EOB is not a bill, but a summary of the financial aspects of your healthcare services.
Key Components of an EOB
Understanding the different sections of your EOB can help you manage your healthcare expenses more effectively. Below are the key components you’ll find on your EOB:
1. Patient Information
This section contains your personal details, including your name, address, and sometimes your insurance policy number. It’s crucial to verify this information to ensure that the EOB corresponds to the services you received.
2. Provider Details
Here, you’ll find information about Sameday Health, that is the healthcare provider who rendered the services. This typically includes Sameday Health’s, location, and contact information.
3. Service Dates
This section lists the dates when you received the healthcare services. Double- check these dates to make sure they match your records.
4. Service Description
The service description provides a summary of the medical services you received. This could include office visits, lab tests, procedures, or any other services covered by your insurance.
5. Amount Billed
This is the total amount that Sameday Health has billed your insurance company for the services rendered.
6. Amount Allowed
The amount allowed is the maximum amount your insurance company will consider for payment based on your policy’s coverage. This amount may be lower than what was billed, depending on your insurance plan.
7. Patient Responsibility
This section outlines what you owe out of pocket, including copayments, coinsurance, and deductibles. It’s essential to understand this section to know what payments you are responsible for.
8. Insurance Payment
Here, you’ll see the amount your insurance company has paid to Same day Health on your behalf. This payment is based on the terms of your insurance policy.
9. Remaining Balance
The remaining balance is the difference between the amount billed and the amount paid by your insurance. This is typically the amount you will need to pay if it isn’t covered by your insurance.
How to Read Your EOB
Reading your EOB might seem overwhelming at first, but with a little guidance, it can become a valuable tool for managing your healthcare costs. Here’s a step- by-step guide to help you navigate through your EOB:
1. Verify Your Information: Ensure that your personal and Sameday Health information is accurate.
2. Check the Service Dates: Match the dates with your records to confirm the services listed are correct.
3. Review the Service Descriptions: Make sure that the services you received are accurately described.
4. Understand the Amounts: Compare the amount billed, the amount allowed, and the insurance payment to understand your financial responsibility.
5. Identify Your Responsibility: Pay attention to the patient responsibility section to know what you owe.
6. Look for Errors: If you notice any discrepancies, such as services you didn’t receive or incorrect billing amounts, contact us or your insurance company.
Is an EOB a bill?
What should I do if I find an error on my EOB?
Why did my insurance pay less than what was billed?
What if I can’t afford to pay the remaining balance?
I just received a notice for service that was performed last year?
I got a notice for a service I paid cash for.
Will I be charged if I give you my insurance information?
Why should I give you my insurance information?
I gave you this information already.
I thought the test was 'free'...
How to contact us
If you have any questions or need more assistance with your EOB, please
contact us. We’re here to help you navigate your healthcare journey.
Rume Medical Group
2729 Bristol St Costa Mesa, CA 92626
[email protected]
888-223-7863