Double-checking EOBs

Provider: Dr. X
Date: 3/15/11
Service: Computed tomography
Charge: $753
Allowed: $243
Paid: $194.40
Patient Responsibility: $48.60

Very curious.

  • I haven’t seen Dr. X since January.
  • Dr. X doesn’t do any imaging in his office; he refers people to an outside facility.
  • This test was not done.  Not there nor anywhere else.

I wonder if someone in the billing office made multiple typos (wrong patient, wrong procedure), or if there’s some fraud going on.  I really hope it was an honest error and they get it fixed without a huge time investment on my part.


3 thoughts on “Double-checking EOBs

  1. I hate it when that happens. I’ve found that it usually takes one quick phone call — to the insurance company. Since they’re paying the $$$, they’re pretty quick to straighten things out. I also make a courtesy call to the doctors office to let them know that I called the insurance company. That gives them an incentive to get on the ball.

  2. I had a similar thing happen last week. The explanation of benefits said that I had attended an office visit with a specialist without a referral. I didn’t have a referral because I never saw the doctor. Took a number of phone calls but I think it is straightened out now. I really don’t like calling the insurance company. Every call takes a minimum of 1/2 hour and I find myself becoming annoyed with the recorded voice asking me questions.

  3. I called the dr office this morning, and they said they’d contact their billing service to return the money to the insurance company. Probably a good idea, because I emailed the insurance company, too.

    I think insurance companies should give patients a share in the money we find for them!

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