I went to ER few years ago, and EOB shows all the services claimed, discounts all those, and the final balance to be $98, which I was waiting for the hospital to send me the final bill for me to pay that amount.

It's now 2 years after, I have not received anything from the hospital, so I called billing office. They say insurance paid everything and I owed $0, but EOB says $98 and no other claims were made.

Is this possible in any way? Can insurance pay more or hospital add discounts or reduce fees without telling or documentation? I don't mind not paying, but I just want to really make sure I don't owe anything - which I double and triple checked with the hospital - they say $0, but EOB says $98, and no other claims were made.

  • An EOB is not a bill. What is the problem? – quid Jun 27 '19 at 1:40
  • Because medical bill follows what EOB says. What concerned me was not ever getting the real bill from the hospital for 2 years.. and hospital says different from EOB.. – Justin Jun 27 '19 at 1:55
  • EOB says $98 what remark or explanation was given with that $98 balance? It's not really your problem, but many provider contracts require the provider to collect certain types of patient responsibilities (i.e. copay). So you may be getting off the hook here but the provider may be violating their contract. – dwizum Jun 27 '19 at 14:02

This is not an uncommon happening (but it's not too common either, unfortunately)

Often, the hospital bills the insurance a huge amount, which the insurance reduces according to their contracts, and then pays it, less your share/deductible. The insurance then expects you to pay your share/deductible.
However, the amount the hospital got is all they expected, and they don't care to run after your share, and just waive it.

Either way, if they confirm you that you don't owe anything anymore, you are good.

I had that happen several times, once with an $8000 bill, reduced to $6100, where the insurance paid ~$4500, and I supposedly owed another $1600 - which the hospital never wanted (and I'm not complaining).

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  • Thank you again for the reply. Should I call the billing office again explaining about what my EOB says and breakdown of the payments? Or should I not risk it? I now moved to different address, and I wanted to tell them to change my mail address just in case if new bill can be mailed, but hospital resisted, saying Honey! You owe $0. – Justin Jun 27 '19 at 1:53
  • No, just forget about it. You are good. – Aganju Jun 27 '19 at 1:55

The $98 might be for a doctor, technician or service who works at the hospital but bills separately from the hospital.

That's a common "tactic" (I hate the word, since it sounds conspiratorial) nowadays.

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  • But even then they should have done so already after two years. – Aganju Jun 27 '19 at 1:43
  • Thank you, I did get a different bill for the doctor, which was $25. $98 was then strictly for the hospital :) – Justin Jun 27 '19 at 1:47
  • Should is the key word. Just like we all should pay off our credit cards every month, not splurge spend on wasteful crud, etc, we don't. Similarly, not every small business (because that's what all these doctors and technicians are) is up to snuff on financial management. – RonJohn Jun 27 '19 at 1:47
  • It's possible that the labs were billed separately, but the billing office would probably have mentioned it if so. And for a hospital, a $98 charge typically isn't worth the cost of staff time to recover. At the two-year mark, they've almost certainly moved on. – Upper_Case Jun 27 '19 at 16:15
  • Thank you, the billing office did mention that if I took xrays or anything, that will be billed separately. But, I did not get any xrays; only labs done were probably blood test. Billing office said everything done at the hospital was covered. EOB lists ER visit and labs under the same provider. Does this mean all the labs were also covered as well right? – Justin Jun 29 '19 at 14:24

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