Detailed Answer
A statement of account—whether it’s from a medical provider, law firm, or other service—generally lists all charges, payments, adjustments, and the remaining balance. Under Indiana practice, insurers or government programs (such as Medicare or Medicaid) do not appear as separate “charges”; they show up as payments or credits applied against your account balance.
Key Sections of a Statement of Account
- Charges: The total billed amount for each service or item.
- Payments/Credits: Funds received on your behalf—this includes insurance reimbursements, Medicare or Medicaid payments, and any government program disbursements.
- Adjustments: Contractual write-offs or negotiated discounts between the provider and the payer.
- Balance Due: The remaining amount you owe after credits and adjustments.
Insurance or government program payments will typically appear in the Payments/Credits section. You may see line items labeled:
- “Insurance Payment”
- “Medicare Payment”
- “Medicaid Payment”
- The name of your specific plan or program (e.g., “ABC Health Plan”).
Some providers allocate each payment directly to the service date it covers. Others list all payments in a summary table at the bottom of the statement. Adjustments may reflect rate differences between the provider’s charge and the amount the insurer or program agrees to pay.
Indiana does not mandate a uniform billing format for statements of account. However, the Indiana Department of Insurance supervises insurer practices under Indiana Code Title 27, Article 1, Chapter 5. You can review those provisions here: Indiana Code Title 27, Art. 1, Ch. 5.
Helpful Hints
- Review your Explanation of Benefits (EOB) alongside the statement to match insurer payments.
- Check payment dates and amounts to ensure timely posting.
- Verify adjustments: contractual write-offs should reduce your balance, not increase it.
- Keep copies of all insurer correspondence and EOBs for your records.
- Contact the provider’s billing department if you see unexplained balances or delays.