EOB – Explanation of Benefits

An Explanation of Benefits (sometimes called a Claims Summary), is a document the health insurance company sends you and your medical providers telling you how your medical claims (expenses) have been processed. For you it is simply an FYI. The EOB lists the treatments that took place, the portion of the cost that is covered (called the negotiated rate), and the amount remaining for you to pay directly to the doctor. From the EOB (or Claims Summary), the doctor (or hospital) will send you an adjusted bill. When you receive an EOB from your health insurance company, keep it filed away in a safe place (where the dog can’t eat it!) so that you have it available for reference when you receive the bill from your doctor.   Use the information on the EOB to make sure your doctor (or hospital) is billing you for the correct amount.