When you receive a statement of account from a healthcare provider in Louisiana, you’ll often see separate columns for charges, payments, adjustments, and your remaining balance. Insurance or government program payments appear in the payment or adjustment sections to reduce what you owe.
Where Insurance Payments Appear
Insurer payments typically appear under a column labeled “Payments” or “Insurance Adjustments.” This entry reflects the amount your private insurer or employer-sponsored plan paid directly to the provider. Under La. Rev. Stat. § 22:1973(B), insurers must furnish an Explanation of Benefits (EOB) showing these payments, so you can reconcile the amount against your statement of account. See La. Rev. Stat. § 22:1973.
Where Government Program Payments Appear
Government program payments—like Medicaid (Title XIX) or other state-funded health benefits—often appear as a separate line item labeled “Medicaid Payment” or “State Program Adjustment.” Providers list these amounts under “Adjustments” because they represent the contractual write-offs or discounts dictated by program rules, as set by the Louisiana Department of Health.
Key Components of Your Statement of Account
- Charges: Total fees billed for each service.
- Payments: Amounts received from insurers or patients.
- Adjustments: Contractual write-offs, discounts, or government program allowances.
- Balance Due: Remaining amount the patient must pay.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. For guidance tailored to your situation, consult a qualified attorney in Louisiana or contact the Louisiana Department of Insurance.
Helpful Hints
- Always compare your statement payments to the insurer’s Explanation of Benefits.
- Watch for terms like “Adjustment,” “Write-off,” or “Contractual Allowance.”
- If amounts don’t match, contact the insurer or provider billing office for clarification.
- Keep all statements and EOBs organized to support any disputes.
- If you suspect billing errors or unfair practices, consider consulting a Louisiana healthcare attorney.