Understanding Your Explanation of Benefits (EOB)

What is an Explanation of Benefits?

An Explanation of Benefits (EOB) is a document provided by your insurance company that provides details about a medical service or treatment you received. It includes what was billed, what your insurance covers, and what you might owe. Understanding the EOB is crucial in managing your healthcare expenses effectively.

Decoding Key Terms on Your EOB

One of the core elements of an EOB is the ‘allowed amount’. This is the maximum amount that your insurance will pay for a covered service. Knowing this amount helps you understand how much you might need to pay out-of-pocket if your healthcare provider’s charges exceed the allowed amount.

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Steps to Review Your EOB

When you receive your EOB, take the time to review it carefully. Start with identifying the services billed and confirm the dates of service. Check the listed amounts charged by the provider and compare them against the allowable limits to ensure you don’t overpay. Also, verify any co-pay or deductible amounts.

Address any discrepancies immediately by contacting your healthcare provider or your insurance company to resolve any billing issues. Keeping correct records helps in managing your medical expenses without surprises.