Understanding Explanations of Benefits vs Explanation of Processing
What is an Explanation of Benefits?
You will receive a Explanation of Benefits (EOB) from your health insurance company if you use your health insurance during a visit to a health care provider.
The EOB is not a bill. No action is required from you when you receive an EOB. If you owe your doctor any money, you will receive a bill from your doctor that will arrive separately from your EOB.
The EOB is for your records to help you understand how your provider coordinated with your health insurance. It provides detailed information about the interaction with that health care provider, including the care you received, the dollar amount covered by your health plan, and the amount you owe the health care provider.
What is an Explanation of Processing?
Your spending account administrator, such as Capital Blue Cross, will send you an Explanation of Processing (EOP) whenever a claim involving your spending account, such as an HSA, FSA or HRA, is processed. Please note that some organizations will refer to this as "Explanation of Payment" but generally mean the same thing.
The EOP is also not a bill and no action is required upon receipt. This is a document that will show whether a claim was processed, the service date, what the claim was, and how much the claim was. Additionally, if the claim was unpaid, a reason will be given on the form.
Claim activity for Capital Blue Cross members can also be viewed anytime online at CapitalBlueCross.com.