If you have insurance coverage, Circle Medical processes a claim for your care after your appointment using the insurance details you have provided. After the claim is sent to your insurance company, they will then process the claim. Once done, they will send you an EOB, which summarizes and breaks down the costs they have calculated.
The EOB typically includes:
Service Summary: A quick glance at the services, total costs, and insurance coverage.
Detailed Breakdown: Specifics of each service, including dates, providers, and individual costs.
Medical Codes: These are standardized codes that are essential for identifying procedures.
Understanding Costs and Coverage
Insurance coverage might not always align with the provider's charges due to negotiated rates. The EOB helps you understand what the insurance agrees to pay versus the total cost.
Accuracy is Key
It’s vital to review your EOB for accuracy. Contact the number on the back of your insurance card, or the member services line, to voice any discrepancies with your insurance provider.
EOB Components
Name | Definition |
Patient and Provider Information | Your details and those of your healthcare provider. |
Service Details | Information on the healthcare services received. |
Provider Charges | The total billed amount from Circle Medical, and any insurance adjustments. |
Insurance Payments | Details of what your insurance has paid, including deductibles and co-pays. |
Patient Responsibility | Out-of-pocket costs, including remaining deductibles and co-insurance. This is the amount that you are responsible to pay. |