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An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: EOB documents are protected health information. Electronic EOB documents are called edi 835 5010 files. There will normally also be at least a brief explanation of any claims that were denied, along with a point to start an appeal.

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  • Explanation of benefits (en)
  • 效益說明 (zh)
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  • 效益說明(explanation of benefits) （一般縮寫為 EOB表）是由寄發的對帳單據，以說明病患所支付的醫療行為和服務。 EOB表通常隨附於支票或對帳單發送。一般會列明： * 收款方，支付方，以及患者。 * 服務項目—服務的日期，描述，代碼，代表人，以及患者。 * 醫療費用，以及保險公司同意的數目—醫療院所主張的費用扣除被保險人的扣除額。 * 患者必須支付的數目 * 寬減的理由與代碼 EOB文件為受保護的健康資訊。 電子式EOB文件為edi 835 5010文件。 表上一般至少會簡要說明遭拒項目，及其聲明理由。 保了第二家保險公司的被保險人須將此資訊提供給自己的保險公司。第二家保險公司一般僅支付EOB文件上所列明的自付額。第二家保險公司的EOB文件列示經其處理後，患者仍須自付的數額。 (zh)
  • An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: EOB documents are protected health information. Electronic EOB documents are called edi 835 5010 files. There will normally also be at least a brief explanation of any claims that were denied, along with a point to start an appeal. (en)
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  • An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: * the payee, the payer and the patient * the service performed—the date of the service, the description and/or insurer's code for the service, the name of the person or place that provided the service, and the name of the patient * the doctor's fee, and what the insurer allows—the amount initially claimed by the doctor or hospital, minus any reductions applied by the insurer * the amount the patient is responsible for * adjustment reasons, adjustment codes EOB documents are protected health information. Electronic EOB documents are called edi 835 5010 files. There will normally also be at least a brief explanation of any claims that were denied, along with a point to start an appeal. A member with secondary insurance gives such information to the provider for the next bill to go out to that insurance company. Generally, secondary insurance pays only the amount the EOB says the member is responsible for. Secondary EOBs show if the patient still has any responsibility to the provider. After the member's insurances have processed the claim, the provider bills the member for the remaining balance, if any. (en)
  • 效益說明(explanation of benefits) （一般縮寫為 EOB表）是由寄發的對帳單據，以說明病患所支付的醫療行為和服務。 EOB表通常隨附於支票或對帳單發送。一般會列明： * 收款方，支付方，以及患者。 * 服務項目—服務的日期，描述，代碼，代表人，以及患者。 * 醫療費用，以及保險公司同意的數目—醫療院所主張的費用扣除被保險人的扣除額。 * 患者必須支付的數目 * 寬減的理由與代碼 EOB文件為受保護的健康資訊。 電子式EOB文件為edi 835 5010文件。 表上一般至少會簡要說明遭拒項目，及其聲明理由。 保了第二家保險公司的被保險人須將此資訊提供給自己的保險公司。第二家保險公司一般僅支付EOB文件上所列明的自付額。第二家保險公司的EOB文件列示經其處理後，患者仍須自付的數額。 (zh)
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