Explanation of benefits (EOB) question...?

Question

so i went to the obgyn for my annual checkup four months ago in April, and i was looking over all of my EOB's today, the EOB for the procedure said i may owe the provider (my doctor's office) $46.33 and a few weeks later after the visit they did send me a bill for it and i paid it...also, i got a separate EOB that same day for the lab work that goes along with the procedure that was sent to and done at the hospital, and it said "amount u may owe provider: $10.36"....however i never got a bill from the hospital for that amount and its been over four months since i got the EOB.....does that mean my insurance paid the $10.36? should i worry about not having received a bill from the hospital?

also, just because it says on the EOB "amount you may owe provider" and then lists an amount, does it sometimes turn out that you may not owe that amount or anything at all to the provider??

Answer 1

Your EB says :amount you may owe provider" because the insurance company has no way of know if you already paid it to the provider or not. You do owe both of those amounts to both providers. They will probably sent you a bill, in fact if they have a contract with your insurance company the contract probably obligates them to bill you for the amount you owe (but if they do decide to write it off, some insurance carriers will not press the issue because it does not affect them financially), this is part of your contract with your insurance company too.  If it was me I would call them and find out if and when they are going to send the bill because, if it was me I would be really ticked if I got a ding on my credit report for such small amounts.

Answer 2

No, your insurer did not pay that amount.

It just means that the provider hasn't sent you a bill yet.  They may be slow billing, or they may not have the correct address on file for you.  Its hard to say.

But, if/when you receive the bill, you are still obligated to pay it.

(If it were a large amount, I'd suggest that you call the provider to ask when you will receive the bill.  If by some chance they had been sending bills to the wrong address, you'd hate to get a large collections statement 3 years down the road.  But I wouldn't say that you "have" to call about missing a bill for $10...its probably safe to wait for it.)

Answer 3

It most likely means, the hospital hasn't gotten around to billing you for it yet.  

Yes, the provider might waive it, especially because it's such a little amount.

I wouldn't worry about it, until/unless you get a bill.

Answer 4

You will probably receive that lab bill soon.  Some providers are extremely slow to bill.

Answer 5

That's the amount you'll owe when they get around to billing you.  I got a bill a week and a half ago from something back in March....4 months later.  

Always match your EOB with your bill.  If they don't match figure out why and don't pay a bill without seeing the EOB first.