EOB’s (Explanation of Benefits)

EOB’s are the reports you get from your insurance company.

Not all EOB’s are identical, but they may have all or some of the following information ~

                       

Patient Name:                              This is the patient that is receiving the services.

Insured’s Name:                          This is the person who carries the insurance policy under them. 

I.D. Number:                                 This is usually on the front of the insurance card and identifies the patient.

Group Number:                           This identifies which group health insurance the patient belongs to.

Patient Account Number:       This is an identifying number the provider-of-services assigns to the patient.  (Each provider has their own patient account number.)

Claim Number:                            This is a number that the insurance company assigns to each claim to identify it.

Dates-of-Service:                        The dates you were seen and had services.

Units-of-Service:                         Denotes the amount of something provided, such as charged hours or medication amounts.

Billed Amount:                             What your provider billed the insurance company.

Allowed amount:                        The amount your provider is contracted to bill the insurance company.

Contractual Adjustment Amount:  The contracted amount that has to be written off the charges.

Notes:                                              Denotes information pertinent to the claim/charges.

Deductible:                                    The dollar amount applied to your annual deductible on the claim.

Co-Pay Amount:                          The dollar amount applied to your annual coinsurance on the claim.

Amount Paid:                                The dollar amount the insurance company paid to your provider.

When calling your insurance company about a claim, always have the EOB available as you will likely be asked information directly from it.