Explanation of Benefit (EOB)

Your customers are ready to pay for your dental service.

They told you they have dental insurance but they don’t understand what is Explanation of Benefit (EOB).

Here are the explanations you can give to your patient:

An EOB is not a bill, but a document that helps you track what your insurance covers and what you’ll owe.

It contains the information below:

• Personal and Plan Details:
  
  Information about your patients, their health plan, the care provider, the date of service, a unique claim number, and contact details for their health plan.
  
  
• Claim Details:
  
  Includes the date they received service and a description of the services, such as medical visits or tests.
  
  
  
• Cost Breakdown:
  
  
  
  • Provider Charges:
    The total bill from you as a healthcare provider.
    
    
    
  • Allowed Charges:
    The amount their insurance agrees to pay for the service, which might differ from the provider’s charges.
    
    
    
  • Paid by Insurer:
    What their insurance will cover for this claim.
    
    
    
• Their Financial Responsibility:
  
  
  
  • Patient Balance or What They Owe:
    The amount they’re responsible for after insurance payment. This does not account for any payments they’ve already made.
    
    
    
• Discrepancies:
  If their bill exceeds this balance, they should discuss it with you as a service provider.
  
  
  
• Remark Codes:
  These are codes (typically 2-3 alphanumeric characters) that provide additional information about their claim. The meanings are found at the bottom of the EOB.

Keep this in your saved file so you can take it out anytime to explain to your patient.

That’s all for today.

Have a happy weekend.