Diagram: Filing system for bills, statements, and EOBs

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Business management guru Peter Drucker once called U.S. hospitals the most complex organizations in human history. I regret that this is in no small part due to the complexity of the relationship between hospitals, patients, physicians, and insurance organizations.

On the opposite page is an example of a patient account statement for a wrist surgery performed on a Medicare enrollee. As you can see, the top line of the statement is over $14,000. An elderly patient receiving this statement might become distressed if he or she did not understand the rest of the statement. Just glancing at this statement one might also believe that the patient owed $388.20 to the facility. That is not the case. In fact, this patient owes nothing. There is a secondary insurance policy that has not yet paid, but will ultimately cover the balance of the amount owed.

34 // The Medical Bill Survival Guide