Understanding your medical bills can be a challenge at times and hopefully this article can help. This quarter we will explain a straight-forward one-time visit. Also, the type of health services coverage such as Medicare, Medicaid, or Commercial Insurance can complicate the information on a billing statement so hopefully we will be able to explain that as well. Please refer to Statement #80005272. In the statement picture there are basically 3 sections.
The top section (A) is a summary section noting your Account Number (number specific to the patient it can also be known as a medical record number), Statement Number (number specific to this statement document), Amount Due and Amount Paid, Statement Date and Date Due along with sections to indicate what type of payment will be included with the stub when or if you need to make a payment. Below this you will find the address information for the responsible person that is on the account along with our address information for the payment submission.
The middle section (B) includes the specifics of the medical services that were provided. The top portion of this section states the Account Number and Statement Number. The bottom section indicates the Patient Name for the service(s) that was provided; the Date of Service and Financial Number (number specific to this encounter or visit date). Then, each service is listed along with the charge for each of the services. In addition to the services, by date are any payments or adjustments that have been processed that correspond to the services that were provided on this service date. Items on this particular bill include a date for when this was billed to the Commercial Insurance Company (04-13-2014 Billed ASSURANT HEALTH/ASC) and then the Commercial insurance payment (05-05-2014) applied to this visit. In this case, the insurance did not send a payment because it most likely applied to the deductible but the allowable charges for these services allowed for an adjustment to the bill which is listed as a “Contractual Allowance Adjustment”. Because we work with many different payors, this adjustment varies according to our contract with each of the individuals’ payors.
The bottom section (C) allows for the ability to describe any remarks that are in the “*R” column in the previous section. This section is helpful to show the status of the billing statement and may also show comments from our facility.
Some of the abbreviated services are at times hard to understand, we have provided a key of abbreviated medical terms specific to medical billing to help you have more clarity and a better understanding of your bill.
Hopefully this brief explanation helps and in future newsletters, we will explain more details of the billing statements. If you have specific questions concerning your billing, please do not hesitate to contact our Business Office at (307) 746-4491 Our staff would be more than willing to help your with your questions. We look forward to serving you!
Maureen Cadwell, CEO
Common Abbreviated Medical Terms Used for WCHS Billing
CMP – Comprehensive Metabolic Panel – Lab Test
CBC – Complete Blood Count – Lab Test
CBC Diff – Complete Blood Count Differential – Lab Test
CRP High Sensitivity – C-Reactive Protein – Lab Test
Sed Rate Automated – Sedimentation Rate – Lab Test
PTH – Parathyroid Hormone – Lab Test
BMP – Basic Metabolic Panel – Lab Test
Chem8 – BMP with Calcium – Lab Test
NT-proBNP – N-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) — a Functional Cardiac Biomarker – Lab Test
Hgb A1C – Hemoglobin A1C Test for Diabetes – Lab Test
Cult Blood – Culture of Blood – Lab Test
TSH – Thyroid-stimulating hormone – Lab Test
HDL – High-density lipoprotein – Lab Test
UA – Urine Analysis – Lab Test
XR …. – X-ray test of a specific body part – Radiology Test
CT …. – Computed Tomography – Radiology Test
EKG – Electrocardiogram
ED …. – Emergency Department