Medical Articles & News

How to Read Your Medical Bill

May 31, 2023 by Christopher Wolfington

How-to-Read-Your-Medical-BillTrying to understand an invoice from your doctor or specialist can be frustrating because medical billing is notoriously complicated. Most invoices include a long list of services and fees that may not make sense to the average person. Learning how to read your medical bill and understanding the components of a medical invoice will help you avoid confusion and be better informed about your healthcare expenses.

FinPay offers solutions for patients, providers, and employers to make understanding medical bills easier. By helping people understand what they're responsible for before they even enter the waiting room, FinPay's platform helps eliminate surprises and creates more transparency when it comes to medical billing. Learn more by emailing today.

A Common Medical Bill Breakdown

While every visit and procedure will include unique information, most medical bills will include some common information, like:

  • Services provided
  • Insurance coverage
  • Patient responsibility

In each section of the bill, you'll find a breakdown of the charges associated with your visit or procedure. This includes everything from copays and coinsurance to deductibles and other costs. It's important to note that insurance may cover some of these charges.

Understanding Your Medical Bill

If you're not a medical provider, it can seem like you need a dictionary to understand what kind of charges are listed on your bill. Some common terms you'll find on your medical bill include:

  • Office visit – Fees associated with routine visits to your doctor
  • Diagnostic tests – Charges for imaging and lab services
  • Treatments/procedures – Charges related to treatments, like physical therapy or surgery
  • Prescription medication – Costs for the drugs your doctor prescribed

The best way to make sure you understand your medical bill is by asking questions. If something doesn't make sense, it's okay to reach out to your healthcare provider and ask for an explanation.

By learning how to read your medical bill, you'll be empowered to make the best decisions when it comes to your healthcare costs and getting the care you need.

Learn About Insurance Coverage

Insurance coverage helps to reduce the cost of medical care, but understanding the different terms and concepts associated with insurance coverage can be confusing. Here are some common terms and definitions related to insurance coverage:

  • Premium – This is an amount that you pay monthly for your health insurance plan.
  • Deductible – A deductible is the amount that you must pay before your insurance will start covering the cost of care.
  • Coinsurance – This is a percentage of the cost of your medical services that you are responsible to pay after you have met your deductible.
  • Out-of-pocket maximum – The out-of-pocket maximum is the most money that you will have to pay for your health care during a policy year.
  • Copay – A copay is a flat fee that you are required to pay for certain services, like seeing a doctor or filling a prescription.

Your medical provider will ask for your insurance information before you see the doctor or specialist. They will then coordinate with your insurance provider to determine your level of coverage and the amount you are responsible for paying.

How to Read Your Explanation of Benefits

An explanation of benefits (EOB) is an important document that helps to explain how your insurance company processed a claim for medical services. An EOB will tell you the total charges for a service, any amount your insurance company paid, as well as any amount you are personally responsible for.

Your EOB will be sent by your insurance company, usually around the same time your medical provider sends you a bill for the expenses you are responsible for. Reading and understanding your EOB can help avoid errors in your medical bill so you don't overpay.

Reconciling Billing Mistakes

Sometimes, your provider may make a mistake in their billing, or your insurance company may not process a claim correctly. If you find any discrepancies between the services you were billed for and those that were actually provided, it's important to reach out to your medical provider as soon as possible to reconcile the discrepancy.

You can use your invoice and EOB to review and compare the services you were billed for and those that were actually provided. If there are any discrepancies, discuss the mistake and arrange a correction before making a payment.

Understand Your Financial Responsibility with FinPay

Now that you know how to read your medical bill, you can approach the care you need with confidence. For extra support, FinPay offers a payment platform to help patients and providers manage their medical bills easily. With FinPay, you can understand your financial responsibility and make payment arrangements that work for you.

Learn more about FinPay to take control of your medical billing process and put your mind at ease. For more information about our services, please click the button.


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Tags: Medical, Patient Financial Management, Patients

Christopher Wolfington, Founder & Chief Revenue & Strategy Officer - FinPay, is a business leader and entrepreneur with over 29 years of experience in consumer and financial services. Mr. Wolfington is currently living in Philadelphia, PA and continues to use his entrepreneurial talent to identify key opportunities and solutions in high growth markets.