Horrifying Medical Bills Part 1

Welcome to a better understanding of the first step in the processing of your medical bill.

The information On Your Claim Form That is Submitted To Your Insurance Company from your provider (doctor or facility) Example: Hospital

1. The Patient's name.

2. Patient's date of birth. (DOB)

3. Date of service (DOS) The day you were seen.

4. The patient's identification number (the number on your insurance card.)

5. The name of the Guarantor (name of person insured). Example: Spouse

6. All doctors have a computer generated identification number as well as the facility itself having its ownnumber. (Doctor's office or hospital)

7. The reason for your visit. Example: Doctor's visit which will have its own independent CPT code. Remember each procdure the doctor performs has its own separate CPT code and with a dollar value assigned to the CPT code.

8. Your diagnosis is assigned a (ICD code.) If you have three different problems each will be assigned a separate ICD code.

9. The contractural (dollar amount) adjustment your doctor or facility has established with your insurance company. It means, that less money for you to pay in the long run.

10. Place of Service (POS) This is where you were seen.--- Example: A doctor's office, hospital, or laboratory.

11. The referral number is assigned to you for your medical visit by the insurance company. This number or referral paper allows you to be seen by your doctor.

12. The authorization number is assigned to you to receive treatment. Example: An x-ray. It's a number or paper from your insurance company for you to receive treatment.

13. If medical records are needed by the insurance company they are attached to the paper claim.

14. The name and address of your medical insurance company.

---Explanation OF Benefits (EOB)---

What do you do when you receive your Explanation of Benefits from your Medical Insurance Company.

How to interpret it--- How to fight back--- will be in part 2. I will dissect the Explanation of Benefits and you will have a better understanding on what can go wrong when processing your medical claim.

The insurance companies love to send the doctor's office or facility complicated Explantion of Benefits. You, as their client, receive the same copy.

The insurance companies rely on untrained people in medical facilities to prepare and submit your claim form. The insurance companies hope the Explantion of Benefits will be accepted at face value and never challenged.

Congratulate yourself, you have now mastered a few words used in Medical Insurance Billing. A little bit of knowledge goes a long way. Watch for part 2. What Your Medical Insurance Company Doesn't Want You To Know.

Please let me know if this article is easy to understand. This is a complicated matter. It can lead to your blood pressure rising and steam coming out of your ears. If you have any questions. ---Ask---