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Every card. Confidence comes misunderstanding your 2016 Explanation of Benefits statement Michigan Public School Employees Retirement System Medicare members Medicare Plus Blue is a PPO plan with

How to fill out explanation of benefits statement

How to fill out an explanation of benefits statement:

1. Start by carefully reviewing the statement: Read through the entire explanation of benefits (EOB) statement to get a clear understanding of the information provided. Pay attention to the dates, procedure descriptions, provider names, and any codes or numbers mentioned.
2. Verify your personal details: Check that your name, address, and insurance policy information are correctly listed on the statement. This ensures that the statement pertains to you and that your insurance benefits are being applied accurately.
3. Match the EOB to your medical bills: Compare the services or procedures mentioned in the EOB to the medical bills you received from healthcare providers. Ensure that the dates, amounts charged, and services rendered align with what is stated on the EOB.
4. Understand the payment breakdown: The EOB will outline how much your insurance company paid, how much you are still responsible for (deductibles, co-pays, or co-insurance), and any discounts negotiated with healthcare providers. Make sure the math adds up and that you understand the financial obligations mentioned.
5. Research any denied or partially covered claims: If you notice that some claims have been denied or only partially covered, take note of the reasons provided in the EOB. It may be necessary to contact your insurance company for clarification or to appeal their decision if you believe it is incorrect.
6. Keep a record and file EOBs: It is essential to maintain a copy of each EOB for your records. File them in a safe place as they can serve as proof of payment, explanations of coverage, and may be necessary for future reference or disputes.

Who needs an explanation of benefits statement?

1. Policyholders: Individuals who have health insurance coverage and have received medical services will receive explanation of benefits statements. These statements provide a detailed breakdown of how insurance benefits are applied, what has been paid, and what the policyholder is responsible for.
2. Healthcare providers: Explanation of benefits statements are also important for healthcare providers as they assist in reconciling payments and understanding how insurance claims were processed. Providers can use EOBs to follow up with patients regarding outstanding balances or any discrepancies between their billed amounts and the insurance payments.
3. Insurance companies: EOB statements are generated by insurance companies to communicate the details of claims processing and the associated payments to their policyholders and healthcare providers. This helps ensure transparency and an accurate understanding of how insurance benefits were applied.

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What is explanation of benefits statement?

Explanation of benefits statement is a document that is sent by health insurance companies to policyholders to explain what medical treatments and services were covered and what costs were paid.

Who is required to file explanation of benefits statement?

Health insurance companies are required to file explanation of benefits statements to their policyholders.

How to fill out explanation of benefits statement?

Policyholders can review the explanation of benefits statement to ensure accuracy of the information provided by the health insurance company.

What is the purpose of explanation of benefits statement?

The purpose of explanation of benefits statement is to inform policyholders about the medical treatment or services that were covered by the insurance company and the costs incurred.

What information must be reported on explanation of benefits statement?

Explanation of benefits statement must include details of the medical treatments or services provided, the amount covered by insurance, any deductible or co-pay amount, and any remaining balance.