When you seek care and a claim is processed by your insurance company, you may receive an Explanation of Benefits, or EOB. This statement shows you how the medical care was paid for, which services were performed and why, and any charges that you may owe out of your pocket.
Here is what you’ll find on your EOB:
- Member contract information
- This includes your name, address, group and contract info listed on your insurance card, and any family members on your plan that may have received care
- Summary of services
- List of medical services
- Savings you received through participating providers
Note: It is not uncommon for patients to receive the EOB before they even see a bill from a doctor’s office. Make sure to match this information to your bills to make sure it is accurate.
- Summary of deductibles and copayments
- Shows you how much of your copays and deductibles you’ve paid to date
- Detail of services
- What type of care you receive, the date of your appointment and your doctor’s name
- Balance due
Here is an example of what an EOB with BCBSM looks like:
Here’s a helpful tip for claims resolution: Always keep a copy of your bill and EOB for the date of service.
As an AFG client, we are happy to assist you in resolving any discrepancies between your bill and the EOB or answer any questions you may have about how your care was covered. What other questions do you have about understanding how your medical bills are processed and paid?
