Understanding Your Billing Slip from Your Insurance Company
Explanation of Benefits (EOB)
Your Insurance Company will send you a copy document explaining what payments were made to your provider for the services that you received. The EOB is not your bill. The EOB arrives to your door prior to arriving to the providers’ office. Below are terms and the explanation of each individual category on your EOB.
-
Amount Due: Amount patient owes provider after all deductions are applied. Unless the deductible or past due amounts from previous dates are applicable, this is the amount that your provider will bill you.
-
Amount Not Covered: This amount is not covered by your insurance according to the provider contract.
-
Billed Amount: The amount that the provider billed for their services and procedures.
-
Claim Number: The number assigned to each claim. The insurance company will ask for this number when you have any questions for them. This will identify that particular incidence.
-
Coinsurance Amount: After you have met your deductible, your cost of coverage is shared by you and your health plan.
-
Contact Information: Where to call for insurance information.
-
Covered Amount: The contractual amount covered by your insurance company according to the submitted procedure code from your provider.
-
Date of Service or Care: Date you were seen at the medical office.
-
Deductible Applied: This amount is applied to the total balance owed. If no amount was paid at the time services were rendered then it is still to be collected by the provider.
-
Deductible/Copay: Amount you owe at time of services rendered. Your contractual portion owed.
-
Discount: Discount applied by your insurance company. It is between your provider and insurance plan.
-
Group Number: This number pertains to your plan. It identifies your company. It should match up with the group number on your insurance card.
-
Identification Number: This number is identifying the person covered on the insurance plan.
-
Patient Name: The name of the person who received the medical treatment (you or your dependent).
-
Processed Date: The date that your insurance company processed your claim in their office.
-
Provider Name: The medical doctor or medical provider or facility that sent the claim.
-
Received Date: The date that you’re insurance received your information from the medical office.
-
Submitted Charges or Amount Billed: This is the dollar amount submitted by your provider.