What does the abbreviation "EOB" signify in health insurance?

The abbreviation "EOB" stands for "Explanation of Benefits." This document is provided by health insurers to policyholders after a claim has been processed. It serves several important functions in the context of health insurance.

An Explanation of Benefits outlines what services were billed by the provider, what the insurance company has approved for reimbursement, and how the payment was determined. This document typically includes details such as the total cost of the service, the amount covered by the insurer, any deductibles or copayments that the insured must pay, and any adjustments that were made to the claim.

Additionally, the EOB helps insured individuals understand how their benefits are being utilized and can assist in tracking healthcare expenses throughout the plan year. It is essential for ensuring transparency between the insurer and the insured regarding payment processes.

The other choices, while they may contain components relevant to insurance communication, do not accurately represent the standard terminology used in the industry. "Evidence of Benefits" and "Essential Overview of Benefits" do not reflect the common practices in billing and claims processes. "End of Benefits" incorrectly suggests a termination of coverage rather than a summary of claims processing.