Message 14 of 15
Statement from your insurerA genuine Explanation of Benefits arrives from your own health plan. It shows the plan paid $1,140 for an office visit and lab tests at a clinic in a city you have never been to. Patient responsibility: $0.
The statement is real, and you owe nothing. What should you do?
Correct. Not quite. A claim for care you did not receive means either a clerical mix-up or someone using your insurance identity. Neither is harmless. False claims can use up benefit limits, and another person’s diagnoses and test results can end up in your medical record, where they may affect your own treatment later. Call the number on your insurance card, say you did not receive the service, and ask for the claim to be investigated. Request a copy of your claims history as well.
More: The Tiny Detail on an Insurance Claim That Can Cause a Big Problem