By: Tenesha Washington
When you hear billing or insurance, it might make your stomach drop. However, it is actually fairly simple. When a claim is submitted to your insurance company by your medical provider, your insurance is required to send an explanation of benefits to you (the patient) and your medical provider.
What exactly is the explanation of benefits (EOB)?
The explanation of benefits informs you, the patient, and your medical provider what is covered by the insurance company, what may be owed to the medical provider and what the patient’s responsibility would be. Additionally, it should also tell you if your provider was paid in or out of network and if it was applied to your deductible or coinsurance.
When you receive medical services at Oklahoma City Indian Clinic (OKCIC), you will not owe OKCIC any payment. Don’t worry if a check for a payment is sent to you for services that you received at OKCIC. Simply endorse the check and bring it to OKCIC.
When you receive the explanation of benefits from your insurance company, you should review the entire benefit. If the insurance company needs more information about your visit, your insurance should include a form to fill out on how to provide the information online. The claim will not be processed until the insurance company has received all the information.
Example of information that could be requested by your insurance company include:
- Coordination of Benefits
- Accident or injury questionnaire
- If the injury is related to work or an automobile accident
- Discrepancy with demographic information
Please remember to bring your new insurance card with you to every visit. Your insurance company provides important information on your card, including addresses to submit claims to and if you have vision and dental coverage.
When showing up for your scheduled appointment, provide OKCIC registration staff the policyholder’s social security number and date of birth. This information is required for OKCIC registration staff to verify coverage.
Many insurance plans have a timely filing limit of 90 days. If OKCIC does not submit the claim to your insurance within 90 days, the insurance plan will not reimburse the clinic for your medical claim.
When OKCIC processes your insurance claims on your behalf, you are helping OKCIC continue to offer and expand the services that are provided to you and your family. If you have any questions regarding claims that have been submitted to your insurance company, please call or email OKCIC’s Billing Director at (405) 948-4900 ext. 425 or email at tenesha.e@okcic.com.