Popular tips

How do you read a BCBS EOB?

How do you read a BCBS EOB?

How do I read an EOB?

  1. The name of the person who received services (you or a family member your plan covers)
  2. The claim number, group name and number, and patient ID.
  3. The doctor, hospital or other health care professional that provided services.
  4. Dates of services and the charges.

How do you explain Explanation of Benefits?

What is an Explanation of Benefits? An EOB is a statement from your health insurance plan describing what costs it will cover for medical care or products you’ve received. The EOB is generated when your provider submits a claim for the services you received.

What is coinsurance on EOB?

Coinsurance – Coinsurance requires you to pay a certain percentage of your medical bill. The percentage is typically 20% or 30%, depending on your health insurance coverage. In this example, the patient has hit their medical deductible with this bill, so the remaining amount they owe is based on 20% coinsurance.

What does an EOB from Blue Cross mean?

After you use your health plan benefits, Blue Cross will send you an Explanation of Benefits (EOB). You may wonder what an EOB is and why you need it. We can help. What is an EOB? An EOB is a statement that shows the health care services you received. It also shows what your health plan paid and the amount you owe.

What are the reason codes for an EOB adjustment?

Adjustment Reason Codes: Reason Code 1: The procedure code is inconsistent with the modifier used or a required modifier is missing. Reason Code 32: Lifetime benefit maximum has been reached. Reason Code 33: Balance does not exceed co-payment amount.

What do you need to know about the EOB statement?

EOB Statement Details This identifies who this EOB statement is for. Summarizes claims by doctor, hospital, or other health care provider as follows: This represents the amount submitted to Blue Cross on the claim. What you saved by being a Blue Cross member. What we paid and amounts your other insurance(s) paid.

Which is the best EOB for Blue Shield?

Not only is our new EOB clearer and more informative about claims processing and benefits, but it also offers more customer-friendly features like: Reinforces the value of utilizing a Blue Shield network provider Details the time it took Blue Shield to process a claim