Retirement and Insurance
Appealing a Medical or Dental Claim
Richard Moseley (CLT) Chairman, Retirement & Insurance Committee Karen Browne MEC Benefits Specialist
D o you know what an EOB is and what you should do with it? EOB is short for Explanation of Benefits and you get one every time a claim is filed with a traditional insurance carrier like United Healthcare, Pru- dent Buyer, Blue Cross or MetLife Dental. If you have an HMO, you probably don’t ever see
them because the claims are usually paid in full once you pay your co-payment at the doctor’s office.
But for those of you who do receive them, here are some helpful hints on how to read one and what to do if you don’t think it is correct.
BLUE RIBBON INSURANCE COMPANY
US Airways Inc.
PILOT NAME PILOT ADDRESS CITY, ST 88888
This is an explanation of the benefits for the bills received on 9/26/99.
Service Bills Dates Submitted
Amount Applied to
$19.00 $14.00 $ 9.00
Actual Benefits Paid
Plan Information – 1999
Indiv. Deductible Family Deductible Individual Coinsur Lmt. Family Coinsur. Lmt. Lifetime Benefits
Plan $150 $400 $500 $1,000 Unlimited
Year to Date
Remarks (RMK): 1 - This amount is your plan’s copayment, which is your responsibility
November/December 1999 – US AIRWAVES