What looks like a bill, but isn’t a bill? An EOB. Your explanation of benefits is a summary of how your benefits were applied to a medical service.
After you visit the doctor, or have a procedure, the provider office should bill your insurance company. (We say “should” because it doesn’t always happen, unfortunately.) Your insurance company processes this claim. Based on the services your benefits include, the insurance company pays for a portion of your care. After processing is complete, the insurance company sends you an EOB, which tells you how they processed the charges. Then, you receive your bill (also known as “patient liability”).
When you get your EOB, keep it. Check this info on your EOB against your bill:
- Name, policy, and group number
- Date you visited your doctor or had the procedure
- Services provided, and Current Procedural Terminology (CPT) codes
If you spot an inconsistency, call the Zest concierge at 866.333.4725 or chat in the Zest app. (You can send a picture of your EOB and bill to us right in the app!)