Explanation of Benefits (EOB)
The statement your plan sends after processing a claim, showing what was billed, what they paid, and what you owe.
An EOB is the document your plan sends after adjudicating a claim. It shows: the billed amount, the allowed amount, what the plan paid, what you owe, and the reason for any adjustment (CARC + RARC codes). EOBs are NOT bills — providers send separate bills. EOBs are critical for tracking deductible/OOP-max progress and for spotting incorrect denials. Always reconcile EOBs against provider bills.
Frequently asked questions
What is explanation of benefits (eob)?
An EOB is the document your plan sends after adjudicating a claim. It shows: the billed amount, the allowed amount, what the plan paid, what you owe, and the reason for any adjustment (CARC + RARC codes). EOBs are NOT bills — providers send separate bills. EOBs are critical for tracking deductible/OOP-max progress and for spotting incorrect denials. Always reconcile EOBs against provider bills.
Related terms
- CARC (Claim Adjustment Reason Code)A numeric code on insurance EOBs and 835 ERAs explaining why a claim was reduced, denied, or adjuste
- RARC (Remittance Advice Remark Code)A supplementary code on EOBs that adds detail to a CARC denial.
- DeductibleThe amount you pay out of pocket each year before your insurance starts paying. Resets every plan ye
- Allowed amountThe maximum amount your plan considers payable for a covered service. Calculated cost-sharing is bas
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