What is a statement of benefits (EOB)?

A statement of benefits, commonly referred to as an Explanation of Benefits (EOB), serves as a crucial document issued by a health insurance company following the processing of a claim. It provides a detailed breakdown of the expenses for a given service, outlining what costs are covered under the policy, what amounts the insurance company will pay, and what the patient is responsible for out-of-pocket.

This document is vital for patients to understand how their insurance benefits have been applied and clarify any remaining financial responsibilities they may incur, such as coinsurance, deductibles, or any non-covered services. It plays a significant role in promoting transparency between the insurer and the insured regarding medical expenses.

While other options include concepts related to finances or administration within an insurance context, they do not specifically address the function and significance of an EOB in the claims process.