An Explanation of Benefits is a notice that includes the details and payments made for services you received.
An EOB is a notice that includes the details and the payments made for services you received. It tells you what the plan pays and what you pay for each service. It also includes information about what to do if we deny payment for a service.
Only the format of your EOB has changed. As before, it describes the services you received, when you received them, the total cost, your share of the cost and our share of the cost. We changed the format to make the information easier to read.
You should review your EOB to help you understand your healthcare costs. It has information about services you received, and it lists your share of the cost for the service and the amount that Peoples Health paid for the service.
Remember, your EOB is not a bill. A provider might send you a bill separately. If you get a bill, call member services. We can help you find out what you owe, if anything.
No. We send you an EOB to help you understand your healthcare costs. There are times when a provider may send you a bill separately. If you get a bill and have questions, call member services. We can help you figure out what you owe, if anything.
It depends. The most important thing to remember is that as long as you get covered services from a provider in our provider network, you only pay your plan copay or coinsurance. You are not responsible for paying any more than that amount. However, if your plan does not have an out-of-network benefit and you received a service from a provider who is not in our provider network and we did not authorize the service in advance, you may have to pay the entire cost of the service.
In either event, if you get a bill from a provider and have questions, call member services before you make any payment. We can discuss the bill with you and help you determine what you owe, if anything.
Healthcare providers have 365 days from the day you receive the service to send us a claim for the service. We also must follow special guidelines when processing a claim. Either one of these reasons could have caused the service to appear on your EOB long after you received the service.
If you think you did not receive a service listed on your EOB, ask your provider to explain the service or call member services so we can help you.
Medicare requires us to send an EOB whenever we pay a provider for healthcare services. Providers have 365 days to send us a claim, and we must follow special guidelines when processing it. Even though you are no longer a Peoples Health member, you received the services you see on your EOB while you were a member of our plan.
If we have paid for a service you received after you were disenrolled from your Peoples Health plan, call member services so we can assist you.
Medicare requires us to send an EOB whenever we pay a provider for healthcare services. Providers have 365 days to send us a claim, and we must follow special guidelines when processing it. This means an EOB may be sent after a member has passed away.
Medicare requires us to send EOBs. At this time, you are not able to opt out of receiving them.