Frequently Asked Questions
An EOB is a document sent by your insurance company to let you know that it has processed a claim for healthcare services on your behalf or for a covered family member. THE EOB IS NOT AN INVOICE OR BILL and is simply an explanation of charges. After the physician ordered a test, MedArbor performed the test, sent the results to the physician, and submitted a claim to
the insurance company. The EOB shows the following:
- A breakdown of the covered amount by the insurance company
- Potential patient co-pays and deductibles
DO NOT MAKE ANY PAYMENT TO MedArbor BASED ON AN EOB.
A. The Medicare program typically requires MedArbor to accept whatever amount Medicare pays (known as the Medicare allowable fee) as payment in full. If you are a Medicare beneficiary, you may be responsible for a 20% coinsurance payment as indicated by the Medicare Professional fee schedule.
The majority of patients have either supplemental insurance (also known as “Medi-Gap”coverage) or other secondary insurance, which will likely cover the entire coinsurance amount. If this is true in your case, you will not be responsible for any payment. A Medicare part B deductible also may apply, in which case you will have to pay the deductible amount.
A. You are only responsible for the amount that you owe based on your health insurance plan and its determination of the allowed payment amount. For example, the total billed to an insurer is $1,000.00, the in- network allowed amount determined by the insurer is $600.00, $525.00 of which was covered and paid by the insurance. In this example, the patient pay amount is $75.00. ($50.00 for remaining deductible + $25.00 for coinsurance). You DO NOT PAY the unallowed balance amount of $400.00.
A. Please contact our Billing Department at 1-888-590-0808 Ext. 798. One of our billing specialist will be able to assist.
A. Certain insurance companies may pay your claim by sending a check directly to you as the insured. This check is the insurance company’s payment for laboratory testing performed by MedArbor will bill you for the amount paid to you by the insurance company. If you receive a check, paid to you on our behalf, from your insurance company, please immediately do the following:
- Endorse the check by signing it on the back and, write “Pay To: MedArbor ” under your signature
- Mail this check to: MedArbor Diagnostics 200 Rittenhouse Circle STE 1 East Bristol, PA 19007
- If possible, include a copy of your Explanation of Benefits (EOB) that originally came with your check. This will ensure that this check is applied to the proper account.
A. MedArbor offers a very reasonable, discounted patient price for uninsured patients to ensure that all patients can have access to these important diagnostic tests.
A. Yes. If a patient can demonstrate financial hardship, he or she may qualify for a discount on, or waiver of patient payment responsibilities. You can learn more about our Financial Assistance Policy by contacting our Billing Department.