What is the purpose of an "EOB" (Explanation of Benefits)?

The purpose of an Explanation of Benefits (EOB) is to provide the insured with a detailed statement that outlines what medical treatments were covered by the insurance policy and how much the insurer has paid for those services. This document serves as a crucial communication tool between the insurance company and the policyholder. It breaks down the specifics of the claims processed, including the allowed amounts, any deductibles or copayments that may be required, and any remaining balance that the insured may owe.

EOB statements help patients understand their financial responsibilities regarding their healthcare costs. They also provide insight into how claims are adjudicated and ensure transparency in the insurance process. By receiving an EOB, patients can confirm that the services were billed correctly and check if there are any discrepancies that need to be addressed.

In contrast, the other options serve different purposes in the context of healthcare and insurance. Unpaid medical bills are typically communicated through billing statements rather than an EOB. A summary of all claims submitted for reimbursement would not focus on the specifics of coverage but rather on general claim activity. A list of approved medical providers is known as a provider directory, which is separate from the processes related to claims and benefits provided in the EOB.