24 C

What Is an Explanation of Benefits?

What Is an Explanation of Benefits?
What Is an Explanation of Benefits?

What Is an Explanation of Benefits? - An explanation of benefits (EOB) statement provides details about a health insurance claim that has been processed. It explains what portion was paid to the health care provider; it also tells you what portion of the payment, if any, is your responsibility.

Medical bills can be confusing. An explanation of benefits (EOB) statement can help break down the various components. If you learn how to read this important document, you'll be able to understand why you owe the charges.

Definition and Examples of an Explanation of Benefits

An explanation of benefits statement is sent to you after a health insurance claim. It lays out the details of the service, the charges from the provider, the amount covered by insurance, and how much money is still due. Each time they provide services to you, doctors, dentists, and other medical professionals will submit claims to your insurance. This is how they receive payment. In turn, the insurance company will send you an EOB. This is to inform you of the claims submitted, how much is being covered by insurance, and how much you owe.1

Any portion of the medical expense not covered by the insurance company, such as a deductible or a co-pay, will be billed by the provider. These charges should be paid directly to the provider.2

The EOB may look like a bill, but it is not. It can also be hard to make sense of. You may need to call your insurance company to ask any questions about the EOB.

The precise layout and form of the EOB will vary by insurance company. But a simple EOB will include:

A summary of your account with important identifying information and claim number.

The details of the claim, including the date and specific services provided.

The accounting, which includes the price of the service, the amount that your insurance is covering, and the difference between the two. (This is sometimes called the "adjustment," "amount allowed," or "contracted agreement.")3

An optional summary of copays, deductible, and coinsurance.

Many insurance providers, such as Blue Cross Blue Shield, will have sample EOBs available on their website. You can review them to become familiar with what EOBs look like and how the information is presented.

How an Explanation of Benefits Works

An EOB can help you avoid paying more than you should for health care. Look over an EOB when it arrives in the mail; then, compare it to your bills to ensure that you pay the correct amount. If you find an error on a bill from a doctor or other provider, call your insurance company. They will help you address the discrepancy.

What if you don't understand why you owe money or simply are having trouble reading the EOB? You can also call your insurance company or your health care provider to explain the details.

If you owe money, ask the insurance company whether this payment will be put toward your out-of-pocket deductible. Or, you may need clarification on charges for certain services, you can ask the provider to explain the services and charges for each. If you think you have been charged in error, ask the provider to go over the entire EOB, line by line. This can help you see whether a mistake occurred.

Just as health care providers can make billing errors, coding errors can occur when insurance companies process EOBs. If you do not understand something on your EOB or you think your insurance policy covers an expense that was not paid, call your insurance company for an explanation.

Importan : What if you find an error on your EOB, and the insurance company cannot fix it promptly, or if there is a disagreement? You may need to have the benefit reviewed in a more lengthy process, or file a formal dispute.

How to Get an Explanation of Benefits

The explanation of benefits statement often arrives via mail. In most cases, it closely resembles a medical bill.

Most insurance companies now provide you with online access to your account. This can include digital access to EOBs. If you don't already have online access to your account, check with your insurance company about how to get it.

Once you've set up an online account, check to see what digital access options your insurer offers. Most will let you sign up for email alerts when EOBs are available. This can allow you to view them immediately, so you won't have to wait for them to arrive in your mailbox.

Key Takeways

  • An EOB is a statement from your insurer. It outlines which portion of a claim it has paid and what portion you will have to pay.
  • You should get an EOB any time your health care provider bills your insurance.
  • Always take a close look at an EOB to be sure the charges are correct.
  • Compare EOBs to the bills you receive from providers and reconcile them before you make a payment.

Insurance Gas/Electricity Loans Mortgage Attorney Lawyer Donate Conference Call Degree Credit Treatment Software Classes Recovery Trading Rehab Hosting Transfer Cord Blood Claim compensation mesothelioma mesothelioma attorney Houston car accident lawyer moreno valley can you sue a doctor for wrong diagnosis doctorate in security top online doctoral programs in business educational leadership doctoral programs online car accident doctor atlanta car accident doctor atlanta accident attorney rancho Cucamonga truck accident attorney san Antonio ONLINE BUSINESS DEGREE PROGRAMS ACCREDITED online accredited psychology degree masters degree in human resources online public administration masters degree online bitcoin merchant account bitcoin merchant services compare car insurance auto insurance troy mi seo explanation digital marketing degree florida seo company fitness showrooms stamford ct how to work more efficiently seo wordpress tips meaning of seo what is an seo what does an seo do what seo stands for best seo tips google seo advice seo steps, Insurance,Health Insurance,car insurance,auto insurance,insurance quote,car insurance quote,insurance quotes,low cost insurance,cheap insurance,cheap car insurance,cheap auto insurance,car cheapest insurance,car insurance quotes,automobile insurance,auto insurance quote,cheap car insurance quote,discount auto insurance,car insurance online,insurance rates,car insurance online quote,cheapest car insurance,donate your car sacramento,illinois asbestos attorney,new york mesothelioma lawyers,tax attorney columbus ohio,phoenix dui attorney,Keyword: donate your car sacramento,car donation san jose,donate car california,donate car sacramento,donate car,donate a car,donate car salvation army,car donation in massachusetts,car donation california,car donation,donate cars,donating car,donate car charity,donate your car,donate my car,car donation in jersey new,car donation in california,san diego car donation,donate vehicle,vehicle donations,car donation virginia,Keyword: illinois asbestos attorney,asbestos lawyer,mesothelioma attorney,mesothelioma lawyers,asbestos attorney,mesothelioma lawyer,asbestos cancer attorney,texas asbestos lawyer,houston asbestos lawyer,illinois mesothelioma lawyer,asbestos claim,mesothelioma attorneys,mesothelioma litigation,mesothelioma attorney texas,mesothelioma attorney houston,mesothelioma lawyer houston,illinois mesothelioma attorney,texas mesothelioma attorney,asbestos litigation,asbestos lawsuit,alabama lawyer mesothelioma
Postingan Lama
Postingan Lebih Baru
THEBOEGIS Theboegis leads the marketing department, organizing and implementing creative and innovative digital marketing campaigns with a background in mass communications & psychology.

Posting Komentar

Tes Iklan
Tes Iklan

Ads Single Post 4