Determining Patient Responsibility

This is the third in a series of posts about the insurance claim filing process. The process can be daunting and seem confusing, but the basic components are fairly easy to understand if you break them down individually. The goal is to help our patients, and everyone else, understand what is actually happening “behind the scenes” when you use your health insurance. You can read the rest of the series by clicking on the link headers at the bottom of the post.

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Basic EOB Terminology

This is a breakdown of the major sections contained in the Explanation of Benefits letter you receive after a medical provider files a claim to your health insurer for medical services provided. More in depth breakdowns of specific terms will be included in future posts on this topic as we finish out the series (outline below).

  1. Subscriber Information:

This is basic identification information, including the name of the policy holder, type of plan, and member identification number of your insurance policy.

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National Doctor’s Day is March 30

March 30 is National Doctor’s Day. According to the cause’s website:

National Doctors’ Day is held every year on March 30th in the United States. It is a day to celebrate the contribution of physicians who serve our country by caring for its’ citizens. The first Doctor’s Day observance was March 30, 1933 in Winder, Georgia. Eudora Brown Almond, wife of Dr. Charles B. Almond, decided to set aside a day to honor physicians. This first observance included the mailing greeting cards and placing flowers on graves of deceased doctors. On March 30, 1958, a Resolution Commemorating Doctors’ Day was adopted by the United States House of Representatives. In 1990, legislation was introduced in the House and Senate to establish a national Doctor’s Day. Following overwhelming approval by the United States Senate and the House of Representatives, on October 30, 1990, President George Bush signed S.J. RES. #366 (which became Public Law 101-473) designating March 30th as “National Doctor’s Day.”

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Wolfpack Wednesdays…on Friday!

Due to the special event this evening at 7:37pm, our favorite “official” Family Care holiday – Wolfpack Wednesdays – will also be celebrated today for a special “Wolfpack Friday” edition. Everyone is encouraged to wear red today to support NC State, but make sure you don’t wear Lousville’s shade of red. We do not want to accidentally send our good vibes to the wrong team.

About Wolfpack Wednesdays:

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Purple Day for Epilepsy Awareness is March 26th

Purple Day has a pretty interesting story. According to their website:

Cassidy Megan created the idea of Purple Day in 2008, motivated by her own struggles with epilepsy. Cassidy’s goal is to get people talking about epilepsy in an effort to dispel myths and inform those with seizures that they are not alone. The Epilepsy Association of Nova Scotia came on board in 2008 to help develop Cassidy’s idea which is now known as the Purple Day for epilepsy campaign.

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Cerebral Palsy Awareness Day is March 25

Cerebral Palsy Awareness Day is relatively new, having been passed by Congress in 2013. But, the disease is not new and probably affects the lives of someone you know. From Children’s Neurobiological Solutions:

March 25th is a day recognized by the United States as National Cerebral Palsy Awareness Day. Cerebral palsy (CP) is a neurological disorder that affects different motor functions resulting in physical disabilities. CP exists on a spectrum, meaning that the severity and depth of disabilities can vary widely amongst those affected.

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What is an Explanation of Benefits letter?

This is the first article in a series about the Explanation of Benefits summaries that the patient receives after their provider files a medical claim. To read the rest of the series, please check out the links below.

What is an Explanation of Benefits letter?

Whenever you receive medical services and your provider files a claim with your health insurance, you will receive an Explanation of Benefits (EOB) letter in the mail from your insurer a few weeks after your appointment. If you are enrolled in an online membership account with your insurer, you may receive your EOBs electronically, instead. The EOB is an itemized statement of the claim filed on your behalf by your provider and gives a detailed summary of the amounts that are required to be paid by the patient. This summary includes all negotiated discounts and reflects the amount still outstanding after the insurer has processed the claim and assigned whatever insurance policy benefits the patient has through their insurance plan. This letter is meant to make sure that the patient is aware of the charges that have been filed on their behalf, thereby decreasing medical fraud and making patients aware of the true costs of their medical care.

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Happy St. Patrick’s Day!

Happy St. Patrick’s Day from Family Care! The image above was done by our medical assistant, Ally, and definitely fits in with the March Madness / St. Patrick’s Day theme we have going on this month. Here are some facts about the holiday and a Irish blessing to help you feel a little more Irish today!

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Brain Awareness Week 2015 is March 16 – 22

Brain Awareness Week is a concept developed by the Dana Foundation. Here is the description of their goal for Brain Awareness Week, according to their website:

Brain Awareness Week (BAW) is the global campaign to increase public awareness of the progress and benefits of brain research. Every March, Brain Awareness Week unites the efforts of partner organizations worldwide in a celebration of the brain for people of all ages. Activities are limited only by the organizers’ imaginations and include open days at neuroscience labs; exhibitions about the brain; lectures on brain-related topics; social media campaigns; displays at libraries and community centers; classroom workshops; and more.

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