Question on "adjustments" months after bill issued and paid

[u/shyahone]

So I am struggling to understand what is going on. I had a remote doctor visit back in May, just the visit and nothing else. I was sent a bill for $233, with an insurance adjustment making the amount I owe $188. It was paid and i moved on.

this week in August, I received another EOB in the mail for that same visit. It has a different type of visit, and the bill is now for $290 with an adjustment making the amount $247, and stating I still owe the $59 remaining.

I have called both my insurance company and the hospital asking what is going on, and literally not one single person I have talked to will even touch my question. Why do i have 2 different bills with different amounts and different procedures on them? They all keep saying, you have a bill from this day and you owe $59. Thats it, they will not speak any other words. I have a paper copy and receipt of the original $188 bill, I have sent PDF copies. They dont acknowledge the PDF copies in any shape or form, and when i asked to speak to a manager, they said they dont have any records of it.

I found on the insurance website today a new issuance from 08/26/25. Its a carbon copy of the original issuance with the numbers changed, and a new box that says "adjustment" at the bottom just saying "date of adjustment 08/14/25.

Can someone PLEASE help me make sense of this insanity? I dont even care if it was a coding error and i owe more, SOMEONE should be able to tell me at least that much, but nobody will.

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[u/megan8086]

Chances are, they submitted a corrected claim to recode it for whatever reason. Why they won’t just tell you that is weird.

[u/shyahone → u/megan8086]

thats whats bothering me. If it was an "sorry, we coded it wrong." that would be an acceptable answer. The fact that nobody is willing to even approach the why and are refusing to acknowledge anything even exists is whats driving me mad.

[u/wistah978]

Are there any CPT codes on the EOBs?

[u/positivelycat]

I am guessing a correction happened.

What are thr codes/ services on the 2 bills.

Also where you were remote at home or did you go into the office and a doctor termed in ( more likely in rural areas)

[u/shyahone → u/positivelycat]

Remote at home. the original bill was Synchronous Audio-Video Visit Est Low Mdm 20 m, the new bill is outpatient/office visit

Visit was done via the doctor's office zoom meeting.

[u/megan8086 → u/shyahone]

Telehealth billing can be a little confusing, but for a regular type office visit, even done by zoom, it should be coded as an office visit. So they sent a corrected claim once they realized the claim was miscoded. Again, why no one can just tell you this is frustrating. I would guess a lot of people who just answer phones and take payments can only see a general ledger of what’s on the bill you’re asking about. They may or may not have access to any notes made on your account related to billing. If a corrected claim was submitted there should be a note in your billing account saying that, but I know a lot of billers don’t follow best practices. And I assure you the phone answer-ers are not trained enough to really understand what they’re seeing and communicate it effectively to the patient. ANYHOO, I’m sorry no one has the ability or cares enough to take five minutes to dive into your account notes to tell you this is what happened. The insurance company definitely doesn’t care to take the time to explain it - they want you off the phone.