Sometimes patients and providers get confused by what an Explanation of Benefits (EOB) and what a Medical Invoice is.
Hopefully I can clarify things a bit.
Explanation of Benefits (EOB)
An Explanation of Benefits (EOB) is a statement of charges generated by an insurance company, ordinarily after seeing a physician.
- How the charges are processed by your insurance company
- Details concerning the services performed by the healthcare provider
- The healthcare provider’s charges
Learning how to read your EOB can help you track your expenses and avoid paying too much for services, it is not a bill.
A medical bill is a statement created by your healthcare provider of the amount that is owed by the patient. It can take over 30 days for you to receive the bill due to processing time and whether or not the provider had to send an appeal or documentation to the insurance carrier. The medical bill should show:
- Payments made at the time of service
- How much your insurance company paid
- How much you owe
You should compare the EOB to the medical bill to determine if the procedures and charges are correct. Mistakes can happen. If you have questions or need help reading either document, do not be afraid to reach out to your provider or insurance carrier.
|Article by Charla Tekin, Implementation Specialist, drchrono
Charla produces product content as part of the Customer Success team at drchrono. She has been working in healthcare and technology since 2006 with a focus on medical sciences and healthcare management. Charla holds a B.S. in Medical Sciences and Masters in Science Management from University of Technology Sydney (UTS).