I believe my child’s doctor is billing my insurance for health plan services that he did not render. How can I find out if his office is billing my health insurance for services my child has not received?

There are ways how you can check the billing of health plan services received by members of your family health insurance. First of all, you should check the Explanation of Benefits (EOB) that your health insurance company sends you. The company sends you an EOB for every claim that it receives. You should make sure that these documents reflect the medical services that you or your family received from your medical providers.

If the EOBs are not accurate and they bill health plan services that you did not receive, then you should notify your insurance company. If your Explanation of Benefits isn’t mailed to you, then you could opt to call your insurance company directly and ask that they reprint copies of your EOBs. You can also ask the company to include a report showing what claims have come through under your account. If you think asking for reports and EOBs is bothersome, then you can just review the claims or EOBs over the phone when you call the insurer.

There are other options to confirm what health plan services have been billed under your family health insurance plan. Your insurer might have a website where you can register to see these claims. It’s important to be wary of billing fraud because it drives up the cost of health care for you and for everyone else. There are a few unethical providers who fabricate services to bill, so you should always check your EOBs or regularly check with your insurance company.

Answer by general public - July 2, 2009 @ 2:57 pm

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