Disclaimer: This article provides general information and does not constitute legal advice.
Detailed Answer
In Vermont, your statement of account (often called an Explanation of Benefits or EOB) lists all charges, payments and remaining balances for services you receive. Insurance or government program payments appear as credits that reduce your overall balance. Statements typically display these payments in one of three ways:
- Payments Section: A dedicated section labeled “Payments,” “Credits” or “Payments Received” shows each payment. You’ll see the payer name (for example, “Green Mountain Medicaid”), the payment date and the amount credited.
- Line-by-Line Offsets: Next to each service charge, the statement lists the amount your insurer or program paid. This offset appears in a column labeled “Insurance Payment,” “Allowed Amount” or “Program Adjustment.”
- Summary Totals: At the bottom, you’ll find subtotals for “Total Insurance Payments” or “Government Program Payments” that reduce the “Total Amount Due.”
Vermont law requires clear explanations of benefits and payments. Under 8 V.S.A. § 4088b, insurers must provide an Explanation of Benefits detailing all payments and adjustments. If a government program such as Medicaid covers part of your bill, those payments must appear clearly to ensure transparency of your financial responsibility. See 33 V.S.A. § 1901 et seq. for Vermont Medicaid provisions.
Helpful Hints
- Look for an “Explanation of Benefits (EOB)” heading at the top of your statement.
- Identify columns labeled “Payments,” “Adjustments” or “Allowed Amount.”
- Match each insurer payment to its corresponding charge to verify coverage.
- Review the balance due at the bottom to confirm all credits applied.
- Keep your statements for at least three years for potential audits or disputes.
- Contact your provider’s billing office if any entry is unclear or seems incorrect.