How To Read Your Doctors Bill

03 Jun How To Read Your Doctors Bill

Ever opened a medical bill and thought, “Wait—I owe how much?!” You’re not alone. At Urban Family Practice, we understand that medical billing can feel overwhelming. But the good news is: most of it can be explained. Here’s a patient-friendly breakdown to help you better understand what you’re being charged and why.

1. Is It Even a Bill? Surprise! The first document you receive is often not an actual bill. It’s likely an Explanation of Benefits (EOB) from your insurance provider.

Quick Tip:

• If it’s from your insurance, it’s an EOB.
• If it’s from us (your doctor’s office), it’s your bill.

2. What Does an EOB Do? It breaks down:

• What Urban Family Practice billed your insurance
• What your insurance covered
• What you might still owe (if anything)

Once we receive the same EOB, that’s when your actual bill gets sent out. And that is the one to review and pay.

3. Why Do I Owe Anything? There are several factors:

• Your insurance details (co-pays, deductibles, co-insurance)
• What service you received
• Whether your deductible has been met

Example: Let’s say the contracted rate for a visit is $100. You paid a $20 co-pay. That leaves $80. If your deductible isn’t met, you may owe that $80. Your EOB will show that insurance paid $0, and we’ll bill you that $80.

4. What If My Bill Is Higher Than Expected? Let’s introduce the buzzword: contractual rate.

Doctors often bill slightly above the contracted rate, not to overcharge you, but because we don’t always know what the insurance rate is. This isn’t shady—it’s a workaround because insurance companies don’t always disclose or update rates clearly.

Important: You should NEVER pay more than the contractual rate.

Example: If we billed $120 but the contract rate is $100, and you paid $20 up front, you owe $80—not $100. That $20 overage? We adjust it off before billing you.

5. Your Takeaway:

• Always wait for the actual bill (not just the EOB)
• Ask us about the contractual rate
• Review your EOB side-by-side with our bill
• Contact us with any concerns—we’re here to help

Conclusion: Understanding your bill shouldn’t be a mystery. At Urban Family Practice, we believe an informed patient is a confident one. If you ever have questions about your charges, reach out. We’re here to support your health—and your peace of mind