How Your EOB is Calculated
Member and Subscriber Information
Have this information on hand if you need to contact TeamCare with additional questions.
Summary of Charges and Payments
An easy way to understand your summary of changes and payments is to think about it like a math equation:
Total amount billed
PPO Discount/Non-billable
Other insurance payments
Previous Payments
– Plan Payment
= Amount you may owe
Total Amount Billed
This is the total amount the provider billed TeamCare.
PPO Discount/Non-Billable
Thanks to your TeamCare benefits, going to an in-network provider means you get discounted rates – this section shows the amount of your discount.
Even if you went out of network, this section still shows the amount of your bill you won’t have to pay. Click here to learn more about the benefits you get using in-network providers.
Other Insurance (COB) Payments & Adjustments
If you have Coordination of Benefits (COB), this is the amount your other insurance is responsible for.
Previous Payments & Adjustments
If your claim was reprocessed, this field will show the amount already/initially paid by your plan.
Plan Payment
This is the amount TeamCare is paying for your services.
Paid To
This is the amount TeamCare is paying for your services.
Amount You May Owe
If you haven’t paid your co-pay, co-insurance, or deductible yet, this field will show the amount you owe. You may have already paid this during your office visit.
Deductible, Out-of-Pocket Limit & Plan Limits Used by Patient
Deductible
This is the amount you’ll pay each year for services before your plan begins to pay.
Out-of-Pocket Limit
The out-of-pocket limit shows the most you’ll have to pay for services each year.
Appeal Procedures
If you don’t agree with the way your claim was processed or the payment amounts shown above, follow these instructions to appeal your claim.
