Explanation of benefits (EOBs) are a key component in understanding medical costs, but the information overload can be dizzying. To understand the true cost of care and the value of your benefit plan, it’s important to review each EOB carefully to confirm services and charges are accurate.
- Wait to pay expenses
An EOB is not a bill but is an important piece in completing the pricing puzzle. EOBs indicate what a provider charged, the amount covered by your benefit plan, and what the patient is responsible for paying. EOBs generally are issued within 30 days of a carrier receiving a claim, but timelines can vary.
- Compare the EOB and bill
Compare the EOB to the provider bill. The provider may over or underestimate the amount owed. Ensure that the type of service and billing codes also match. If there are unrecognizable charges for supplies or services that you cannot recall receiving, contact the provider for further clarity. While EOB layouts vary by carrier, common fields include service details like medical codes, provider name and location, the patient’s member ID, total provider charge, the carrier’s allowed and paid amounts, and the patient’s cost share.
- Remit or remediate payment
If the provider statement and EOB mirror cost and services received, patients can pay the provider with confidence. If there are discrepancies between the EOB and bill, contact your Bukaty Companies representative for assistance in resolving the issue.
EOBs are one of the many tools that provide clarity on health care costs. For more resources to boost employee education, contact your Bukaty Companies representative.