Bill 5 of 15
Specialist’s bill, in networkTotal charge: $1,200.00
Insurance adjustment: $0.00
Insurance paid: $560.00
You owe: $640.00
Insurance adjustment: $0.00
Insurance paid: $560.00
You owe: $640.00
Your deductible is already met. What is the right move?
Correct. Not quite. The clue is the adjustment line showing $0. An in-network provider has agreed to accept the plan’s allowed amount, which is nearly always lower than the full charge. The difference should appear as an “adjustment,” “contractual write-off” or “network discount.” Here it is missing, so you are being asked to pay the discount yourself. Check the EOB for the allowed amount and ask the office to apply it.
More: “Insurance Paid” Doesn’t Mean “You Owe $0.” Here’s the Math