What is an Explanation of Benefits (EOB)?

An Explanation of Benefits (EOB) is a document provided by an insurer that outlines the medical services covered, the payment made by the insurance company, and the patient's financial responsibility. This document is essential for both the healthcare provider and the patient, as it helps clarify what costs are being accepted by the insurer and what remains the patient's obligation after insurance has processed a claim.

EOBs serve multiple purposes, including detailing the amount billed by the provider, the allowed amount determined by the insurance company, the co-pay or deductible amount due from the patient, and any services that may have been denied or not covered. By providing this information, EOBs facilitate better understanding and transparency regarding the billing process and what is due from the patient.

Other options, while related to healthcare costs and insurance communication, do not accurately represent the primary purpose or function of EOBs. For instance, a document that guarantees future medical treatment coverage may imply a contractual obligation, which is not the case with EOBs. Similarly, while a report detailing patient costs is important, it does not encompass the comprehensive nature of an EOB, which also outlines what the insurance has paid. Lastly, while notifications about insurance policies play a role in insurance management, they do not serve