Explanation of Benefits

An explanation of benefits is a statement you receive after a claim payment has been processed by your health plan. It explains whether the service is covered,how much was paid, and how much you owe, if applicable. If a service was not paid for, the explanation of benefits will give the reasons for denying payment and will tell you how to file an appeal, if you so choose. An explanation of benefits is not a bill; if you owe money, you should wait to get a bill from your doctor.

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