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wdfifteen wdfifteen is offline
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Join Date: Mar 2008
Location: SW Ohio
Posts: 29,676
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Does anyone understand health insurance?

I got an EOB from my insurance company this morning. I don't know how they can call something this arcane an "explanation" but that's a different matter.

One procedure was billed at $448. (Medicare allows $247.51.) My insurance company will pay $81.76. I paid $16.35 to the doc and insurance company paid $65.41. The doc says we're square - he's been paid in full.

Another procedure: Charged $146.00. Insurance allowed $9.51. The doc accepted $9.51 as payment in full.

How can medical billing be anything but fiction when bills for $448 are routinely settled for $81 and a bill for $146 is settled at $9.51 without protest?
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Old 06-06-2011, 06:54 AM
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