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Explanation of Benefits (EOB)

Each time a medical insurance claim is processed by an insurance carrier, the carrier sends the insured this document which outlines how the insured’s benefits were applied to the particular medical claim. An EOB typically includes, but is not limited to:

 

  • Date that service was  received
  • Amount billed
  • Amount covered
  • Amount paid by insurance carrier
  • Remaining balance owed to the provider by the insured
  • Amount credited towards deductible
  • Any claims that were denied

 

An explanation of benefits is not a bill. It should, however, be kept until the final bill is received from the provider, and used as a cross-reference guide to ensure that the amount charged on the bill is equivalent to an itemized total of the amount owed for each service received. All in all, the EOB is meant to be a tool to confirm bills, and help determine where money can be saved in the future.

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