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You’ve been to the doctor and paid your copay. How are you going to know when your claim is filed and finalized? Simple, you’ll get your Explanation of Benefits (EOB). Your EOB will break down the service you received at the doctor’s office, the cost and what you might have to pay.
What is an EOB?
An EOB is a notice you get when a health care benefits claim is processed by your health plan. The EOB shows the expenses submitted by the provider and how the claim was processed. In most cases, an EOB will be mailed to you after a claim has been finalized. If you are a Blue Cross and Blue Shield of Texas (BCBSTX) member and signed up for paperless statements, you'll get an email notice when your EOB is ready for viewing through your Blue Access for MembersSM (BAM) account .
The EOB has three main sections:
Below is a sample EOB that labels all the sections. Keep in mind, every plan is different and the charges on your EOB are according to your plan’s coverage and the services you received.
Key areas of your EOB:
Your EOB is an important record of claims for medical services paid from your benefits. You need to carefully check your EOB. You want to be sure that the services you received match the services you were billed for. If something looks wrong, call us using the number on the back of your Member ID card or call your doctor to ask about it. Then, keep your EOBs for future reference -- just in case questions come up later about your claim or your bill. (Bonus: if you’ve registered for BAM, we store your EOBs there for 18 months.)
We know it gets a little tricky, so if you have questions about this explanation of your Explanation of Benefits, sign in and let us know in the comments below.
If you want to learn more about EOBs, go to BAM or check out any of these great Health Care Coverage 1-on-1 videos.
Originally published November 18, 2014
Hi Dennis, The BAM website will house all of your plan-specific information, so your EOB and plan information will be there. That information is not available here on Connect as this website is not connected to your plan-specific information. ~ Kayla
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