Question

If a patient notices an unknown item in the explanation of benefits they receive from an insurance company and they do not recognize the service being paid for, the patient should_____.

A) Ignore it, as it might be a mistake.
B) Contact the insurance company for clarification.
C) Wait until the next explanation of benefits for more information.
D) Report it to the healthcare provider immediately.

Answer 1

Patients should contact their insurance company for clarification if they spot an unknown charge in their explanation of benefits to prevent potential billing errors or fraud. So, the correct answer is option B) Contact the insurance company for clarification.

Step-by-step explanation:

If a patient notices an unknown item in the explanation of benefits, they receive from an insurance company and they do not recognize the service being paid for, the patient should contact the insurance company for clarification.

This step is essential to ensure that the patient is aware of the services charged and can verify whether the services were actually received or if there is a potential error or fraudulent charge.

With health insurance policies often involving deductibles, copayments, or coinsurance, it is crucial for policyholders to monitor their explanations of benefits to safeguard against incorrect billing and to understand their financial responsibilities.

So, the correct answer is option B) Contact the insurance company for clarification.