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Posted on Monday, September 9th, 2019

Wellmark Blue Cross Blue Shield, our health insurance provider, will provide an Explanation of Benefits (EOB) each time a health or prescription claim is processed. Understanding your EOB is very important. The document tells you:

1. Your doctor’s appointment/service, or prescription, has been reviewed by Wellmark.

2. How much our health plan account will pay towards what is owed for the appointment.

3. What you will owe as ‘patient responsibility’.

An EOB is not a bill, if you owe anything the bill should come from the doctor's office. By knowing your plan, and reading your Explanation of Benefits, you can double check what you are paying towards your appointment or service is correct. You should always receive an EOB prior to receiving your bill, this way you understand why you are being charged.

For example, your provider could incorrectly submit a claim resulting in Wellmark denying the claim. You could then receive a bill for the service when UNI’s plan actually covers the service that you received. By understanding your health plan, you can double check these charges and save yourself money. If you have questions on any charges relating to your health insurance, please call the number on the back of your Wellmark ID and/or your provider. To learn more please watch our video.