What does an Explanation of Benefits (EOB) provide to patients?

An Explanation of Benefits (EOB) is a document that health insurance companies provide to patients following the processing of a claim. It serves as an essential communication tool that details how a claim was handled, ensuring transparency in the billing process. The primary purpose of an EOB is to inform patients about what services were covered by their insurance policy, the total amount billed by the healthcare provider, and how much the insurance company paid versus what the patient may owe.

This document also typically includes information about any deductibles, copayments, or coinsurance that the patient may need to pay. It acts as a summary that aids patients in understanding their financial responsibilities and the specifics of their insurance coverage. By clearly showing the portion of the costs that are covered and the amounts that the patient is responsible for, the EOB helps promote informed decision-making regarding healthcare expenditures.

Additionally, the other options do not encapsulate the primary function of an EOB effectively. While a summary of treatment or a breakdown of costs might provide useful information, they do not specifically convey the critical information about coverage and billing amounts like an EOB does.