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The EOB is sent to the policyholder after a claim has been submitted to the insurer, typically by a health care provider. EOBs provide a detailed summary of the claim filed, how much the insurance company covered, and how much the insured still owes.
General information about you and your health plan Your health plan. Who provided your care, and when it was provided. A reference number called the claim number. The person who gets reimbursed for any overpayments, called the payee.
An EOB provides essential information, including but not limited to, treatments performed, dentists fees, insurance payments, amount you may owe for deductibles, co-pays, or procedures not covered by your policy, coordination of benefits information (if applicable), the portion of your annual maximum that has been
An Explanation of Benefits (EOB) code corresponds to a printed message about the status or action taken on a claim. Providers will find a list of all EOB codes used with the corresponding description on the last page of the Remittance Advice.
An EOB typically includes: Your name. Your plan information, including name and member ID. The doctor, health professional or facility that provided services.
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The EOB will show a variety of information, including details about the medical treatment, the amount that was billed, the amount that the health plan allows for that service, the amount the health plan paid (if any), and the amount that the patient owes.

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