An Explanation of Benefits (EOB) is a document provided by a health insurance company that details the costs associated with medical services received by a policyholder. It is not a bill but rather a summary that explains what the insurance company covered and what the patient may owe.
The EOB typically includes key information such as the date of service, the healthcare provider's name, the type of service or procedure performed, and the total cost charged by the provider. It also breaks down how much the insurance company paid, any discounts applied, and the portion the patient is responsible for, including copayments, deductibles, or coinsurance.
The EOB may indicate if a claim was denied and provide reasons for denial, along with instructions for appeal. Reviewing the EOB is important for identifying billing errors, understanding out-of-pocket expenses, and ensuring accurate insurance payments. By keeping track of EOBs, patients can manage healthcare costs more effectively and prevent unexpected medical expenses.