{"id":3706,"date":"2015-10-06T20:39:52","date_gmt":"2015-10-06T20:39:52","guid":{"rendered":"http:\/\/hnetalk.com\/member\/?p=3706"},"modified":"2015-10-27T19:13:48","modified_gmt":"2015-10-27T19:13:48","slug":"understanding-your-monthly-medicare-part-c-explanation-of-benefits","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/member\/understanding-your-monthly-medicare-part-c-explanation-of-benefits\/","title":{"rendered":"Understanding your monthly Medicare Part C Explanation of Benefits"},"content":{"rendered":"

As required by Medicare, Health New England (HNE) sends Part C Explanation of Benefits (EOB) to Medicare Advantage members on a monthly basis. The purpose of the monthly Part C EOB is to keep you informed about the medical and hospital claims submitted to HNE on your behalf. This monthly statement shows how much HNE was billed for the service you had and how much HNE paid to your provider.<\/p>\n

Typically, you should receive a Part C EOB at the end of the month for the claims HNE has processed in the previous month. You can determine what you will owe for services in the \u201cYour Share<\/em>\u201d column of the EOB.<\/p>\n

Be sure to review this document each month to verify that you received all of the services listed.<\/p>\n

Top 5 things to remember when reviewing your monthly Part C EOB<\/strong><\/p>\n

    \n
  1. The Part C EOB is not a bill<\/em>.<\/strong> It is a statement to help you keep track of your medical and hospital claims. If you owe any cost sharing, you will receive a bill from your provider. HNE does not bill members on behalf of the providers.<\/li>\n
  2. It helps you to keep track of how much you\u2019ve spent toward your yearly Maximum Out-of-Pocket costs, including copays and coinsurance.<\/li>\n<\/ol>\n
      \n
    1. If there is a claim denial, you will see the reason for the denial and how to file an appeal with HNE.<\/li>\n
    2. If you find a service you don\u2019t believe you received, please call HNE Member Services. We can assist in researching the service further to determine if the claim was sent to us incorrectly by your physician\u2019s office. Sometimes HNE is billed by ancillary providers you don\u2019t meet during your office visit, such as radiologists who read your x-rays, lab technicians, or anesthesiologists and doctors who saw you while you were in the hospital.<\/li>\n
    3. This report covers medical and hospital care only. If you have Part D prescription drug coverage, you will receive a separate EOB for your Part D prescription drugs from National Pharmaceutical Services (NPS).<\/li>\n<\/ol>\n

      <\/p>\n

      \nPlease keep your monthly Part C EOBs together in a safe place with other important medical documents. You may find them useful later in the year as you evaluate your plan choice during the annual enrollment period or when trying to remember what important preventative services you received throughout the year.\n<\/p>\n

      If you have any questions regarding this information, please call Member Services at 413.787.0010<\/span> or toll-free at 877.443.3314<\/span> (TTY\/TDD: 800.439.2370<\/span>). A representative will be available to speak with you from 8:00 a.m. to 8:00 p.m., Monday through Friday (October 1 through February 14: 8:00 a.m. to 8:00 p.m., seven days a week).<\/p>\n","protected":false},"excerpt":{"rendered":"

      As required by Medicare, Health New England (HNE) sends Part C Explanation of Benefits (EOB) to Medicare Advantage members on a monthly basis. The purpose of the monthly Part C EOB is to keep you informed about the medical and hospital claims submitted to HNE on your behalf. This monthly statement shows how much HNE […]<\/p>\n","protected":false},"author":11,"featured_media":3707,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[17],"tags":[332,313,316,331],"class_list":["post-3706","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicare","tag-eobs","tag-explanation-of-benefits","tag-medicare-advantage","tag-medicare-part-c"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/member\/wp-content\/uploads\/2015\/10\/senior_couple_bills-e1443733016769.jpg?fit=700%2C467&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZGa-XM","_links":{"self":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/3706","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/comments?post=3706"}],"version-history":[{"count":9,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/3706\/revisions"}],"predecessor-version":[{"id":3792,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/3706\/revisions\/3792"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media\/3707"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media?parent=3706"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/categories?post=3706"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/tags?post=3706"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}