An explanation of benefits documents the billed charge, the allowed amount under the payer's contract, the contractual adjustment written off, the payer's payment, and any patient responsibility.
It is generated by the payer rather than the provider.
Alternative Names:
EOB, Remittance Advice
Why it Matters?
The EOB is where the gap between billed and accepted amounts becomes visible, and in states permitting evidence of amounts accepted it can reduce claimed specials substantially. It also reveals whether a claim was submitted to insurance at all, since treatment financed by letter of protection shows no payer activity. Requesting EOBs alongside itemized statements is what makes the analysis possible.
Frequently Confused with
Related terms
Frequently asked questions
What does an EOB reveal?
How does it identify letter of protection treatment?
