Why are EOBs (explanation of benefits statements) and provider bills so hard to understand?
Sometimes it seems that you need a PhD to read an EOB! If you follow a simple doctor visit with a visit to a specialist or two, and they order various tests, it can get pretty complex, pretty fast. Sometimes you don’t even recognize the name of the provider that shows up on the EOB, compounding the problem of figuring out how much you will end up paying, to whom, for what.
Weeks, or sometimes months later, various medical bills trickle in from the individual doctors, hospitals, and labs. You then put on your accountant’s hat and try to reconcile all of them against what the EOBs hinted is your share. Ahhh – frustration!
To their credit, my health insurance provider, BlueCross BlueShield, has attempted to put a lot of this information online, keeping it current and clickable behind a secure log-in. However, I still get confused. For example, are the amounts listed under “Deductible Amount” the costs that will end up being billed to me by the medical provider? On the EOBs themselves, there’s no explanation of what the various headings really mean. Then there are the quirks that detract from the online experience. For example, in clicking on the tab labeled “Printable EOBs,” there is no place on the page that is a “print” button. And when I do print, it only prints one page, not all of the pages in this year’s EOB listing. And there is a section for HRAs and FSAs, but not for HSAs, which is what I have, making it extremely difficult to reconcile what I’ve been billed, by everybody, with what I’ve actually paid out this year.
I did come across a company called Simplee that is trying to help consumers make sense of their healthcare expenses. Their mission is to empower consumers to take control of healthcare expenses by helping us understand and manage them. Simplee is a free website that centralizes all your health care information in a HIPAA-safe environment and displays it in a dashboard style to make it intuitive and easy to understand. As an added bonus, the company has ways to detect billing errors, which most consumers would never catch. Once you create your account, Simplee will guide you through getting all of your health care accounts online. Linking your accounts to Simplee will alllow them to access your healthcare plan information and display it all for you in a way that makes sense. Key idea: in a way that make sense!
In the absence of simplified billing (which may arrive with the move to bundled payments), we have to work our way through the maze. So I applaud Simplee in their effort to empower healthcare consumers to deal with the frustrating world of EOBs and medical bills.