Detailed Answer
When you receive a statement of account from a medical provider, creditor, or service vendor in Wisconsin, it lists all charges, payments, adjustments, and credits. Insurance or government program payments appear as a credit that reduces your outstanding balance. They usually show up under a titled section such as “Insurance Payments,” “Third-Party Payments,” or “Payments and Credits.”
Understanding a Statement of Account
A statement of account is an itemized record of all financial activity on your account. Typical sections include:
- Charges for services rendered or goods provided
- Payments you made directly
- Adjustments, write-offs, or discounts
- Insurance or government program payments
- Remaining balance due
Where Insurance or Government Program Payments Appear
Look for a line item labeled one of the following:
- Insurance Payments: Payments made by your private insurer.
- Medicare/Medicaid or Other Government Program: Payments by federal or Wisconsin Medical Assistance.
- Third-Party Payments: A catch-all term for any payer other than you.
These payments will be listed as credits and subtracted from your total charges. For example:
Charges: $1,200.00 Insurance Payment: – $900.00 Patient Responsibility: $300.00
Relevant Wisconsin Law
Providers must give you an itemized statement on request and apply third-party payments correctly. Key statutes include:
- Wis. Stat. § 628.34 (Prompt payment of health insurance claims) – requires insurers to process claims within 30 days. See § 628.34
- Wis. Stat. § 146.83 (Access to medical records) – grants you the right to review billing records and explanations of benefits. See § 146.83
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney for advice on your specific situation.
Helpful Hints
- Review your Explanation of Benefits (EOB) from insurers to match payments with statement credits.
- Check for duplicate entries or missing payments; request corrections if needed.
- Request an itemized bill in writing if any entry is unclear or appears incorrect.
- Keep copies of all statements, EOBs, and correspondence for at least six years.
- Contact your provider’s billing department promptly to resolve discrepancies.