What are Explanation of Benefits and why does it matter for your Virginia car accident case?

If you’ve been injured in a Virginia car accident, and you’re lucky enough to have health insurance, we always advise that you use your health insurance for the medical bills. If your health insurance, in fact, paid part (if not all of your medical bills), you’ve likely received Explanation of Benefits (EOBs).  You may also wonder whether they matter for your car accident case?  Here’s why they are super helpful:

EOBs help you determine whether you owe any money out of pocket.

In the United States, medical billing is a mess.  Often, you receive multiple bills from different providers for one procedure or one ER visit. So, you have to make sure that you are on the lookout for bills that you may owe.  If there’s a bill that’s owed, and you don’t pay it, medical providers will send your bills to collections and damage your credit.

This certainly applies to car accident cases.  Even when you’ve used your health insurance, stay in touch with your providers make sure your bills were actually submitted to and paid by health insurance.

(FYI – if you are treated by an “in-network-provider” of your health insurance, the provider is required by Virginia law to submit those bills to health insurance for payment, or they may forfeit being paid at all).

One benefit of EOBs is they will lay out how much your health insurance plan paid for a particular bill.  And the EOBs will also usually tell you whether you personally owe money.  Whether it’s because of a deductible or co-pay, you need to make sure that you’ve paid any amounts you owe from a particular medical bill.  You cannot simply assume that the bills have been paid in part (or all) simply because they have been submitted to your health insurance company.

Check the bills themselves.  But also make sure to review your EOBs.

They help you double check what bills you incurred.

Just to reiterate from above, medical billing in the US is a mess.  Make sure to review your EOBs because, oftentimes, you’ll realize that you incurred medical bills that you didn’t even know about.  For instance, if you go to the Emergency Room, in addition to the hospital bills, you should expect separate billing for the emergency physicians, imaging, and ambulance transport.  That’s essentially for different bills for a trip to the ER.

By reviewing your EOBs, you’ll have another source to ensure you’ve obtained all of your bills.  And, in turn, you’ll make sure to claim them for your Virginia car accident case.  Remember, if you don’t claim a bill, you won’t be compensated for it.

EOBs help you determine what amount the insurance company may be asking for reimbursement.

As we’ve written previously, your health insurance company may also have a right to reimbursement if you obtain money in your car accident case.  If you have a health insurance policy that has a right to reimbursement, EOBs will show you how much your health insurance plan paid on your behalf. Remember, the Plan only has rights to be reimbursed what they paid out, which will typically be less than the actual price of the medical bills.

Do you have more questions about your Virginia car accident case? 

For more information, make sure to check out our Virginia Car Accident Practice Page. You can also call us at Ph. 703-570-4180 for your Free Consultation. James Abrenio is an award-winning Personal Injury and Criminal Defense lawyer. To learn more about James, click here. You can also read his real client reviews here