Finance and valuation
Explanation of benefits
An explanation of benefits, or EOB, is a written statement from a payer, sent after it processes a claim, that shows the charges covered or not covered and what the patient may owe.
The ADA's glossary defines an explanation of benefits as a written statement to a beneficiary from a third-party payer, after a claim has been adjudicated, indicating the charges covered or not covered by the dental benefit plan. An EOB is not a bill. It explains how the plan handled a dental claim. Practices usually receive their own version with the payment, often called a remittance, and post it to the account. Reading EOBs helps the team find underpayments, denials and the balance a patient owes. EOBs also show how the plan applied its allowed amount, which links to the fee schedule and usual and customary fee.