How To Read Your Explanation Of Benefits (EOB) FMD00000000 FM00000000 1 2 3 4 5 (Name of Provider) 1234E4321 6 7 8 9 10 11 1234E4321 (Name of Provider) 12 JANE DOE 7 1. Group - The number that is linked to your FirstCarolinaCare Medicare Advantage plan. 8. Billed by Provider - The amount billed by your provider for each service you received. 2. Member ID - The number on your FirstCarolinaCare Medicare ID card that is unique to you. 9. Allowed Amount - Maximum amount on which payment is based for covered healthcare services. 3. Payee - The name of the doctor, group practice, hospital or other medical provider who provided a service or product to you. 10. Paid By Plan - The amount FirstCarolinaCare has paid to your healthcare provider, based upon allowed amount. 5. Date of Service - The date a service was provided. 11. Provider May Bill - The amount you may owe after FirstCarolinaCare has paid on your claims. Use your EOB to verify any provider bills you receive before sending payment to your healthcare provider. 6. Type of Service - The description of a specific service. 12. Total Amount - The totals for all columns. 4. Claim - Each claim is given a unique identifying number. 7. Reason Code - Each code explains why an amount was paid, denied or not covered by FirstCarolinaCare. Each Reason Code is explained on the EOB. FC MDCR 14_04_02
© Copyright 2024 ExpyDoc
