Explanation of Benefits (EOB) or Remittance Advice – In many cases these terms are used interchangeably; however, they are different. The Explanation of Benefits is sent to a patient that explains how the insurance processed their services rendered, what was paid or not paid to the provider, and what the patient owes. The Remittance Advice provides information to the healthcare facility or office on whether they need to appeal the claims processing or accept the processing as received. Review the Explanation of Benefits (EOB) from Cigna and CMS

Explanation of Benefits (EOB) or Remittance Advice – In many cases these terms are used interchangeably; however, they are different. The Explanation of Benefits is sent to a patient that explains how the insurance processed their services rendered, what was paid or not paid to the provider, and what the patient owes. The Remittance Advice provides information to the healthcare facility or office on whether they need to appeal the claims processing or accept the processing as received. Review the Explanation of Benefits (EOB) from Cigna and CMS

Practical Management Science

6th Edition

ISBN:9781337406659

Author:WINSTON, Wayne L.

Publisher:WINSTON, Wayne L.

Chapter9: Decision Making Under Uncertainty

Section: Chapter Questions

Problem 37P

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