A Guide to Understanding Your Medical Bill

Most people don’t look at their medical bills in much detail. This can mean that they end up paying more than they need to for their healthcare. So if the amount on the bill seems reasonable, they will just trust that it is right without ever questioning the information contained therein.

Unfortunately, errors can occur, and simple mistakes with diagnosis codes, for example, could have a knock-on effect on the treatment codes entered and, as such, the amount you end up paying. The experts at say that you should get into the habit of checking the information on your medical bill and then looking up codes to see if they coincide with the treatments you received.

What to Look for in a Medical Bill?

After your appointment at the doctor’s office or visit to a hospital, a claim will be sent to your insurance company. This claim will include your details, policy number, and all the information pertaining to your visit. The insurance company will look at the information on the claim form and assess which treatments you are covered for before determining how much money will be paid to the doctor or hospital. You will usually be sent a form known as an Explanation of Benefits (EOB). The EOB contains the information regarding your treatment and how much is being paid to the doctor. It will also include details about how much you will have to pay towards your treatment.

The EOB is not the same as the medical bill. Your medical bill will usually arrive after the EOB. The medical bill may not contain all the details about the care you received, but you can request an itemized bill to compare with your EOB. If the EOB shows that you owe money but have not received a bill, you should contact your medical provider to see if it has been sent (there is a chance it went to the wrong address). If it’s not paid on time, it could be sent to a collections agency. This could then affect your credit score.

Look at the bill to ensure that it matches your EOB. Check all the details, including your name, address, and policy number. If the amount you owe on your EOB is different to that on your medical bill, contact your insurance company to find out why. The itemized bill will help you if there is a discrepancy. You might find that you were accidentally charged for the same treatment twice, or billed for a more expensive treatment than the one that was provided. Sometimes a wrong digit entered can be to blame. If there are any obvious mistakes, contact your doctor’s office or hospital billing department to highlight it.

If the mistake is not rectified immediately, make sure that your bill is placed on hold until the matter is resolved. You can write to the medical provider to explain the situation. It might be that the mistake has come from the insurance company’s end. If this is so, you should still get in touch with the medical provider to explain why you are not paying the bill. Most medical providers will put the bill on hold for anything up to 90 days.


It is important to compare your medical bill to your EOB to ensure they match up. If you find a discrepancy, then you can request an itemized bill from your medical provider. This will make it easier to spot any mistakes. Even if the two documents marry up, it is a good idea to make sure you have not been charged more than necessary.

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