Real answers for your healthcare questions
What is an Explanation of Benefits and how do I read it?
Answer
An Explanation of Benefits, or EOB, is a statement from your health plan showing how a medical claim was processed. It is not usually a bill.
What to Know
The EOB typically shows what the provider charged, the plan's allowed amount, what the plan paid, what was applied to your deductible, and the amount you may owe. It can also show a denial reason or adjustment code if the plan did not pay all or part of the claim.
What to Do Next
Compare the EOB with any bill from the provider before paying. If the amounts do not match or something looks wrong, contact the insurer and provider before assuming the balance is correct.
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