What document details the services provided to a patient and the amount owed by the insured?

The Explanation of Benefits (EOB) is a crucial document in the healthcare billing and insurance process as it provides a detailed account of the services rendered to a patient. It outlines the specific medical services covered under the patient’s insurance plan, the amount billed by the healthcare provider, the amount that the insurance has approved, any deductions or adjustments made, and the total amount for which the patient is responsible.

This document serves not only as a summary of claims processed but also as an important communication tool between the insurance company and the patient, ensuring that the patient understands their financial obligations. It clarifies the cost breakdown and can help patients see any discrepancies or understand their coverage better.

Other documents serve different purposes; for instance, the Patient Ledger is used by healthcare facilities to track and record all financial transactions related to a specific patient. A Claims Form is submitted by healthcare providers to insurance companies to initiate the payment process but does not detail what is owed. Finally, a Patient Agreement outlines the terms and conditions under which services are provided, including payment responsibilities but does not provide the specific breakdown of services and payments like the EOB.