Explanation Of Benefits

A summary of health care charges that your health plan sends you after you see a provider or get a service. It is not a bill. It is a record of the health care you or individuals covered on your policy got and how much your provider is charging your health plan. If you have to pay more for your care, your provider will send you a separate bill.
Statement date is the date your insurance company printed and sent your document to you.
Document number is a reference number you can give your insurance company so they can easily look up the document if you call them with any questions.
The unique number assigned to you by the insurance company so that they can identify you.
The group plan number is the number your employer is given to identify their employee health insurance policy. A group mumber is issued when your health insurance is provided through your employer.
Your insurance company& online address. This is a great resource to use for looking up information about your plan, paying your monthly premium, or finding a customer service person to speak with using the internet.
This is a phone number that you can call to have questions about your plan answered, and to update your account information.
The name of the person who is elegible for covered services.
This is a number assigned to the individual claim described on the EOB that the insurance company uses in their computer system.
Date paid is the date your insurance company paid your provider the amount shown on the EOB.
Date of service is the date you received health care from your provider for the services billed.
Service description is a description of the health care services you received, like a medical visit, lab tests, or screenings.
You might pay $10 or $20 for a doctor's visit, lab work, or prescription. Copayments are usually between $0 and $50 depending on your insurance plan and the type of visit or service.
If your deductible is $1,000, your plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services.
If the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.
Juanita saw on her EOB that her co-pay for the doctor's visit was $15. Since she had already paid her deductible that year, so that was blank on her EOB. Because insurance covered the rest of the cost of that visit, she only owed $15, which was shown under the 'Patient Responsibility' column.