An explanation of benefits (commonly referred to as an EOB) is a statement sent by a health insurance company to members explaining which medical services were paid for on their behalf and which costs the member is responsible for.
The EOB is not a bill. It's an explanation of any charges the member still owes or may have already paid. If the member owes extra money after the insurance company has paid its part, the provider will send a bill. This should match what the member owes as listed on the EOB.
For costs covered by Sana, we'll send payments directly to the provider. If you need to be reimbursed for out-of-pocket costs, you'll need to file a reimbursement claim through Sana.
Do I send payment to Sana?
No, you will always send payment to your doctor's office.
Where does the EOB show patient responsibility?
Patient responsibility is under the claim breakdown in its own separate box.
What do the codes mean?
Each service on your EOB will likely include a remark code that identifies how the claim was processed. Descriptions for each remark code are available at the bottom of each EOB. Remark codes can indicate if a charge is applied to the member's copay or deductible, but they can also indicate a contractual discount or a denial.
When will I receive my EOB?
Statements are sent out monthly to the address on the subscriber's account.
Who receives the EOB for a dependent over 18?
Sana sends the subscriber the EOB for all services on all dependents under their account.