An Explanation of Benefits is the form sent to you or to the medical provider explaining exactly what your primary health insurance provider will or will not cover. It gives you information such as the date of service, the medical providers name, the medical facility's name, the amount of the bill, whether the bill was paid, the amount of the payment, whether it was applied to the deductible or rejected and the reason for rejection.

After you receive care from a physician, we will file your insurance claim. Once the insurance carrier has audited the claim, they will mail a copy of their payment to our physician to your home. The EOB is a line by line explanation of payments, contractual write-offs, and will indicate the portion of the bill for which you are responsible.

Answer: An explanation of benefits is sent to your home after you have received services from either your doctor, hospital,dentist, etc. This explains to you what benefits were paid from your plan on either yourself or the member of your family that had the services rendered. This is not a bill, and should not be confused with one. You will see the column that states "you pay". That column represents the amount you owe to your doctor, hospital, etc.

Hold on to all EOBs and bills. Except for your yearly eye exam, you are responsible for the charges reflected on any bill you receive. If the bill is for the yearly eye exam or if you have a question about a charge, you should bring the bill along with the corresponding EOB to the UHS Benefits Office (Blalock 144).

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A full explanation on how to read your EOB can be found on AccessBlue, our secure online members-only portal on www.bcbsne.com. Just click on the How to Read Your EOB link.

The rows are read from top to bottom. Each separate bill submitted to Cheap is on its own line, with corresponding payment details. EOB messages give additional information about how your expenses were considered, if applicable. The last column of each row shows the amount paid for each bill, and the payment box in the lower right corner shows you where the payment was sent.

These are documents showing a detailed listing of how your insurance company processed your claim or bill. An EOB or EOP is mailed by your insurance company directly to you.

If your claim has not been paid and has been put in a "hold" status awaiting additional information or payment, your EOB will have a description of any additional information necessary for the claim to be processed and an explanation of why such information is necessary. If your claim has been denied, your EOB will have a reference to a specific plan provision on which the determination was based and a description of your plan's appeal process.

If you have questions about an EOB determination, you may contact Customer Service toll free at 1-800-843-1329 or write to: Health Advantage Customer Service, P.O. Box 8069, Little Rock, Arkansas 72203. This is an informal request and is not considered a formal appeal.

Members will receive EOBs when there is an amount owed by the patient (deductibles, coinsurance, etc.). In situations where it is noted that the member has already paid an office co-pay, no EOB will be generated, since the claim is paid at 100%. Yes. The plan will pay 50% of covered services with a lifetime maximum of $1,000. Covered expenses include diagnostic procedures and appliances to realign the teeth. The $50 plan deductible will apply if not met for the year.

EOB stands for Explanation of Benefits. The EOB is NOT a bill, but simply explains your insurance coverage.

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