Disclaimer: This article is for informational purposes only and does not constitute legal advice. Please consult a qualified attorney or accounting professional for advice tailored to your situation.
Detailed Answer
In North Dakota, statements of account (also called billing statements or periodic statements) must clearly list all charges, payments and adjustments. While state law does not prescribe the exact layout, best practice—and guidance under North Dakota Insurance Department rules (see NDCC § 26.1-27.1-05)—indicates that insurance and government program payments appear in a dedicated Payments & Adjustments section as credit entries. This section typically sits just below the list of charges and above the Balance Due line.
• Insurance Payments: These are amounts your private insurer has paid on your behalf. They should show as a payment credit, often labeled “Insurance Payment,” “EOB Payment,” or by the insurer’s name and claim number.
• Government Program Payments: Payments from Medicare, Medicaid or other state/federal programs appear similarly, often labeled “Medicare Payment,” “Medicaid Adjustment” or “State Program Payment.”
Each entry should include:
- Date of Payment: The date the carrier or program remitted funds.
- Payer Name: The insurance company or government agency.
- Claim/Check Number: Reference to the Explanation of Benefits (EOB) or remittance advice.
- Amount: The exact payment or adjustment amount as a credit.
Under NDCC § 26.1-36-09 (billing requirements for health care providers), providers must accurately account for all payments and adjustments. While that statute focuses on healthcare providers, its principles apply broadly: clear, itemized statements avoiding surprises for the account holder.
Example layout (simplified):
Charges $1,200.00 Payments & Adjustments Insurance Payment (ABC Ins. Co.) –$800.00 Medicare Payment –$300.00 ------------------------------------------------------------------------------------ Balance Due $100.00
Helpful Hints
- Review Your EOB: Your insurance Explanation of Benefits spells out exactly what was paid and should match the statement credits.
- Match Check Numbers: Ensure the claim/check numbers on your statement align with the insurer’s remittance advice.
- Ask for an Itemized Bill: If your statement groups payments in ways you can’t decipher, request a fully itemized statement under NDCC § 26.1-36-09.
- Watch for Adjustments: Write-offs, contractual allowances or co-payments may appear separately from insurer payments; look for “adjustment” line items.
- Keep Records: Save all EOBs, remittance advices and account statements to verify accuracy and resolve discrepancies.