What is an Explanation of Benefits (EOB)? 

Navigating health insurance can be complex, but understanding your explanation of benefits (EOB) is crucial for managing your health care expenses and ensuring your coverage functions as intended. This information is typically sent after you receive medical services and can help you understand what your insurance is covering and what you may still owe.

What is an Explanation of Benefits?

An EOB is a statement provided by your health insurance company after you receive medical services. It is not a bill but rather a detailed summary of the services you received, the amount billed by the health care provider, the amount covered by your insurance and any remaining balance you may need to pay. Receiving an EOB can help you understand how your benefits are applied and ensure that billing has been conducted accurately.

What Information Should Be Included in My EOB?

Your EOB typically includes several key pieces of information, including the following:

• Patient information—This section includes the name of the patient who received the services.

• Provider information—This details the health care provider or facility you or another insured visited.

• Service description—These compose a list of the medical services or procedures performed by the provider.

• Charges—This information totals the amount billed by the provider for the services rendered.

• Allowed amount—The amount your insurance company considers reasonable for the service. You may be responsible for the difference if this is less than the charges.

• Insurance payment—This is the portion of the allowed amount that your insurance covers.

• Patient responsibility—The amount you owe, including deductibles, copayments and coinsurance, is listed here.

• Additional remarks—This section includes any additional notes or explanations, such as reasons for denied claims or adjustments.

We’re Here to Help

Contact V Financial Insurance Group today to learn more about EOBs and other aspects of your coverage.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.