The numbers on the diagram to the left correspond to the numbered explanations below.
1. An EOB is not a bill. It is an overview of the total amount the provider charged, how much Senior Care Plus paid, and the amount you are responsible for. You may get a bill separately from the provider.
2. Service description is an overview of the healthcare services you received, like a medical visit, lab tests, or screenings.
3. Billed charges is the amount your provider billed Senior Care Plus for your visit.
4. Allowed charges is the amount your provider will be reimbursed based on your plan’ s benefits and the amount the in-network provider is contracted to be paid. If the provider is not contracted with Senior Care Plus, we allow the same amount Medicare would pay for the same service. This may not be the same as the billed charges.
5. Not covered amount is the difference between the billed charges and the allowed charges.
6. Copay, deductible and co-insurance is the amount you are responsible for according to your plan’ s benefits. You will see this broken-down service-by-service( line-by-line) in this section.
7. Total expected cost is the sum of the deductible, copay, coinsurance and any non covered amounts you are responsible for. You may have paid the total expected cost at the time of the service in the form of your copayment.
8. Reason code is a code that explains more about the costs, charges and paid amounts for your visit.
9. Code summary is a note that corresponds with the reason code that explains more about the costs, charges and paid amounts for your visit.
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