Detailed Answer

When you receive a statement of account for medical services, legal fees or other billed charges, payments made by insurance companies or government programs typically appear as credits or adjustments. These line items reduce your outstanding balance and show how much of the charge the insurer or program covered.

How Payments Are Listed

• Insurance Payment or Adjustment: A credit entry often labeled “Insurance Payment,” “Insurer Adjustment,” or the name of the insurance plan. This reflects the amount your insurer agreed to pay under your policy.
• Government Program Payment: If a public program like Medicare, Medicaid (MaineCare) or Veterans Affairs covers part of the cost, you’ll see an entry such as “Medicare Payment,” “MaineCare Payment” or “VA Adjustment.”
• Contractual Adjustment: The difference between the provider’s billed charge and the insurer’s allowed amount. Under Maine’s prompt-payment law, insurers must pay or deny clean claims within 30 days (24-A M.R.S. §4303).
• Patient Responsibility: After credits, the remaining amount—co-pay, deductible or coinsurance—appears as your balance due.

Example Statement Layout

Helpful Hints

• Review your Explanation of Benefits (EOB) alongside the statement to understand insurer adjustments.
• Look for line items labeled “Adjustment,” “Write-off” or “Allowed Amount.”
• Contact the billing office if entries aren’t clear or seem incorrect.
• Keep copies of statements, EOBs and payment records in one folder for easy reference.
• Ask for an itemized bill if charges or adjustments are aggregated without detail.

Disclaimer: This article is for informational purposes only and does not constitute legal advice. For specific guidance on your account statement or insurance matters in Maine, consult a qualified attorney or billing professional.