Fraud and Abuse Prevention

Understanding my Explanation of Benefits (EOB)

Always review your Explanations of Benefits (EOBs) and medical bills to ensure that the services billed were actually performed by the provider indicated and on the date specified. You can learn more about the information contained within your EOB visiting the PGBA Web Site.

Should you have a question about your bill, contact the doctor who provided the services, or the PGBA Claims Line at 1-800-403-3950.

Guidelines to Help Prevent Fraud and Abuse:

Keep track of every bill received or paid by your insurance provider to make sure that you are not billed more than once for the same service.
Do not be afraid to question your health care provider about the necessity of each procedure that is being ordered for you, especially if it seems excessive.
Do not accept a discount of medical payments or the waiver of your co-payment unless you are assured that the discounted amount is reflected on the billing for your health care provider.

Last Reviewed: July 11, 2008