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July 13, 2016
An Explanation of Benefits (EOB) Statement is a notification provided to members when a healthcare benefits claim is processed by your insurance company. The EOB outlines the expenses submitted by the provider and shows how the claim was processed. In most cases, an EOB will be mailed to you after a claim has been finalized. If you signed up for paperless statements, you will instead get an email notice when your EOB is ready for viewing through your member portal.
When you receive your EOB, don’t just glance at it and toss it aside. It’s an important record of claims for medical services and benefit coverage, so you should always carefully check your EOB. Double check that the services you received match the services you’ve been billed for. If something doesn’t quite look right, call us at the number on the back of your Member ID card or ask your doctor about it. Keep your EOBs on file for future reference — just in case questions come up later about a claim or your bill.
The EOB has four sections:
The EOB may include additional information:
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