{ "media_type": "text", "post_content": "Help me understand the medical system here in the US,I see that a portion of the bill is covered by my insurance but when I check online, I see a you “may” owe section.Haven’t received any bills. Why?", "post_id": "5c47715e51e44b0013d57ee5", "reply_count": 11, "vote_count": 0, "bowl_id": "599b9d5f9970bf0010772e8d", "bowl_name": "Audit Bowl" }

Help me understand the medical system here in the US,I see that a portion of the bill is covered by my insurance but when I check online, I see a you “may” owe section.Haven’t received any bills. Why?

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A relevant life skill I learned from my experience auditing revenue for a major hospital group was they oftentimes write off small balances, or may not bill a larger balance for a crazy amount of time.

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This is really good to know, thx!

Is that what it says on your Explanation of Benefits? If so, I would expect a bill from the service provider within 4-6 weeks of the date on the Explanation of Benefits, if you didn't already pay it at the time of service (e.g. copays)

The provider bills the insurance company. The insurance company provides the EOB to you and responds to the provider with the contractual amount that you have to pay. Then provider sends you bill that is already past due

That’s a portion of the bill you’re responsible for after the insurance company pays their part of the bill

Unless you receive a bill no further action is required. The insurance company tells the doctor/etc. how much they are allowed to bill you, but they may actually bill less.

It’s been 3 months and I haven’t received a bill but I see portion of my deductible has been used, why is that so?

Because the insurance company assumes the doctor, when in network, is going to charge you that deductible per the contract between the doctor and the insurer. How much was the amount owed? Some doctors will write off small amounts or not send a bill until it meets a minimum amount.

yeah, if you are really concerned and want to budget for it, feel free to call your doctor to verify they are not expecting any payment from you. but as people said above. if nobody sends you an actual bill, you don’t owe anything.

Not always true. I had a doctor with the wrong address, their error not mine. They sent a bill it got returned. They wrote it off. 2 years later I went to the same doctor, they wouldn’t see me until I paid for the old bill.

Yea there can always be reasons why you haven’t been billed but that doesn’t mean you won’t eventually get slammed with a bill. If you really want to know call your doc.

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