Explanation of Benefits (EOB) Definition

An Explanation of Benefits (EOB) is a statement provided by health insurance companies to policyholders that outlines the details of healthcare services, treatments, or supplies that have been processed and paid for on their behalf. It explains how the insurance company has adjudicated each claim, including the amount paid, any deductible, co-insurance, or co-payment applied, and any remaining balance that may be the patient’s responsibility.

EOBs serve as a summary of healthcare billing and insurance transactions, helping patients understand the costs associated with their healthcare services. They provide transparency regarding insurance coverage, payments made by the insurance company, and any patient financial responsibility. EOBs are essential for patients to verify the accuracy of insurance payments and to reconcile healthcare expenses with their insurance coverage.