What does EOB stand for in a healthcare context?

In the healthcare context, EOB stands for "Explanation of Benefits." This document is generated by an insurance company and is provided to policyholders after a medical claim has been processed. The EOB outlines what medical services were billed, the amount covered by the insurance, any patient responsibility (such as copayments, deductibles, or coinsurance), and the reasons for any denied or reduced claims.

The EOB serves an essential role in the revenue cycle by ensuring transparency between the healthcare provider and patient regarding the healthcare costs and the insurance coverage applied. It helps patients understand their financial obligations after receiving care and provides insights into how claims were evaluated by the insurer, facilitating the billing process and resolving any questions a patient might have about their out-of-pocket costs. This communication is critical for maintaining trust and clarity in the healthcare transaction process.