Misleading insurance company paperwork, Chapter 436

Filed Under: Costs, Health plans, Patients


Is it a payment or an adjustment? Wait, it’s both! This bill for a colonoscopy clearly identifies the sum of $722.13 as both a payment and an adjustment. The vertical “payments” column is quite clear. Just as clearly, there was no payment at all, judging from the horizontal selection.

We have seen a lot of insurance company paperwork, and it can be incredibly misleading. (Actually, provider and pharma paperwork is misleading too.) This is only one example: To look at more, jump on over to this post, which collects what we call our menagerie of paperwork, to help you negotiate and understand what that misleading pile of papers actually means.

Once upon a time, an insurance company exec told me; “Those explanations of benefits are hard to understand. We do it that way intentionally.” No surprise there.