Insurance EOB question

hopeful34

I am looking at my EOB's from u/s & bloodwork i've had done in the past to see how much i'll have to pay out of pocket when i do ivf (ins covered everything for iui's)

Question is what # do I look at? The billed charges or the allowed amount? It looks like my insurance only paid the allowed amounts on all of my bills. Please help!!

Thanks! 

 

ashlyrose

The billed charges are the charge for the office visit or ultrasound. The allowed amount is what the insurance is "allowing" to pay. If you owe anything it should appear under "patient liability". What the ins paid for that visit should appear under "paid to provider". There may be a spot that says "adjusted/discounted" amount. That is the amount that the office "writes" off. Hope that helps. 

piccolina09

Hopeful, I know you go to cny as did I. You may want to know they code everything as diagnostic. My insurance did not cover the actual IVF procedure, but every single visit monitoring to beta was covered because of the way it was coded, they did not code it as "IVF monitoring". I paid the amount you see on the website the day of retrieval, so if for some reason you are cancelled, you do not have to pay the large lump sum until the RE actually performs your ER. However if you do the grant, you do have to pay upfront only because they give you all the drugs.