What is typically included in the explanation of benefits (EOB)?

The explanation of benefits (EOB) is a crucial document issued by insurance companies to inform patients about the status of their claims. It typically includes details about the claims processing, allowing patients to understand what services were billed to the insurance, how much was covered, and the reasons for any denials if applicable. This information is important for patients to understand their financial responsibilities and the outcomes of their claims.

The inclusion of reasons for denials is particularly significant because it provides insight into why certain charges were not covered, enabling the patient to address potential issues with the claim or seek further clarification from the provider or insurer.

In contrast, service provider demographic information, marketing material about the insurance policy, and the patient's insurance premium rates do not provide the detailed claims processing information and reasoning essential to the EOB. Instead, the EOB focuses specifically on the transaction between the provider, insurer, and patient regarding the care received.