What is an "Explanation of Benefits" (EOB)?

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An "Explanation of Benefits" (EOB) is a statement issued by an insurance company that provides detailed information about medical services received and how those services are covered under a patient's health insurance plan. It outlines what medical services were billed, what the insurance has paid, what the patient is responsible for paying, and how these amounts were determined. This transparent breakdown helps patients understand their financial responsibility for healthcare services and how their insurance benefits are applied.

In the context of managing healthcare costs, an EOB serves as a critical communication tool for patients, allowing them to verify the accuracy of the charges and to grasp the details of their insurance coverage. For example, an EOB not only details the amounts paid by the insurer but also notes any deductibles, coinsurance, or copayments that the patient must fulfill. By offering clarity on each service, the EOB helps patients to better navigate their healthcare expenses and any remaining financial obligations.

In contrast, the other options do not precisely capture the essence of an EOB. While emergency services coverage is important, it is not the focus of an EOB. Additionally, a yearly summary report of medical expenses or a notice about claim rejections does not fit the function of an EOB, which specifically addresses the

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