Ascension_Personalized_Care_ACA_health_plan_Read_an_EOB

Explanation of Benefits

Knowing how to read your Explanation of Benefits, also called an EOB, is important because it can help you understand the costs and benefits associated with the services you received.

Guide to reading your EOB

An EOB is a helpful tool for keeping track of your Ascension Personalized Care healthcare benefits. It shows you how your health plan processed a healthcare claim. EOBs look similar to a bill, but they function differently. The EOB will be in the form of a letter that includes a chart showing how your claim was processed. Always check your EOB, and make sure the information displayed is accurate. If any information is missing or if you have questions regarding your EOB, contact the customer service number located on the back of your member ID card.

See the list below of key elements included in your EOB. You can also download the Guide to Reading your EOB here.

Key elements of an EOB

  • Name of patient: Make sure your name or the name of another person who is covered by your health plan is displayed on the EOB.
  • Insured ID number: This should match the number on your member ID card.
  • Claim number: The number by which you and your health plan will be able to refer to a claim should you have questions or concerns.
  • Provider: The name of the healthcare provider who provided this service. This could be the name of a specific doctor, or of a hospital or other location.
  • Date of service: The start and end date of the service.
  • Type of service: A description of the service received.
  • Healthcare provider charge: The amount billed to your health plan by the healthcare provider.
  • Cost covered by your health plan: The total your health plan paid for your services.
  • What you owe: Any balance the healthcare provider billed that was not covered by your health plan.