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    Health Care Reform:

    Health Insurance & Affordable Care Act

    Your Guide to Health Insurance Paperwork


    9. What is a bill?

    A bill is a request for payment from your health care provider. It will show how much you owe for your medical care after your insurance has paid its share.

    10. What information is on a bill?

    It should include:

    • The name and address of the medical provider
    • The date of the bill
    • Your name, address, and account number
    • The date of treatment
    • The patient's name if it's not you
    • A description of the medical service that was given
    • How much you were charged
    • The amount your insurance paid for the service
    • The remaining amount that you owe
    • Other unpaid charges that you might have had before this bill

    11. How can you check to see if you're being billed correctly?

    First, see if you got an EOB from your insurance company about the services in your medical provider's bill. This is very important, because some doctors and medical facilities will send you a bill before your insurance company has paid it.

    These early bills show the full amount you're being charged, not just your share of the cost. You don't have to pay these early bills, but some people do so by mistake. You only have to pay the amount still owed after your insurance company has paid its share.

    If you get an EOB from your insurance company, you should hold it side-by-side with the bill to compare:

    • The dates of the medical care
    • The services the provider is billing for
    • The amount the insurance company has agreed to pay
    • The amount you owe

    12. What if you have questions about a bill?

    Call your health care provider's office if you have questions about the dates of your medical care or the description of the services or care.

    Call your insurance company with any questions about payment. For instance, you might want to find out why your insurance didn't cover a charge or paid only part of the amount.

    13. How can you fight a bill?

    You have the right to appeal any decision by your health insurance company. The Affordable Care Act requires that health plans provide an internal appeals process. This lets you challenge claims that your insurer rejected. You also can find out more about why they were rejected.

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