Detailed Answer
Overview: A statement of account is a summary of charges, payments, adjustments, and the running balance for services rendered. In Maryland, health-care providers and other entities must itemize all payments received, including those from private insurers and government programs such as Medicare or Medicaid, in compliance with MD Health–General § 19-214(e). This ensures transparency and helps patients or account holders verify that third-party payments have been properly credited.
1. Credit Columns and Line‐Item Descriptions
On most statements of account, you will see at least three columns:
- Date: When a charge, payment, or adjustment occurred.
- Debit (Charges): The cost of services or products provided.
- Credit (Payments/Adjustments): Funds received or adjustments applied.
Insurance or government program payments appear in the Credit column. Each line shows the payer’s name or code—e.g., “Blue Shield” for private insurance or “Medi-Cal” style codes for Medicaid. These entries reduce your outstanding balance.
2. Adjustments vs. Payments
Sometimes statements group contractually agreed write-offs (the difference between the provider’s full charge and the insurer’s allowed amount) under an “Adjustments” heading. Under MD Health–General § 19-214, providers must also show these adjustments separately from patient responsibility. Government program discounts or write-offs appear here, while the actual check or electronic remittance posts as a payment.
3. Running Balance
Every credit—whether private insurance, Medicare, Medicaid, or other government program—applies against the previous balance. The statement’s rightmost column typically shows the running balance after each payment or adjustment.
Relevant Statute: Maryland Health – General § 19-214(e) (“Each bill shall include the total charges submitted, payments received (including those by government programs), and patient liability.”) https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=19-214.
Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney or billing specialist for guidance tailored to your situation.
Helpful Hints
- Look for a Credit or Payments column—insurance and government payments post there.
- Check line-item descriptions for insurer or program names and service dates to match payments against charges.
- Distinguish between adjustments (contractual write-offs) and payments (actual funds received).
- If the statement isn’t clear, request an explanation of benefits (EOB) from your insurer or government program.
- Keep all statements and EOBs until you confirm your account balance is zero or fully resolved.