Office Administrative Assistant Practice Exam

What document identifies what was billed, paid, rejected, or denied, in addition to any claim adjustments?

1. Patient invoice

2. Claim summary

3. EOB

4. Billing statement

The correct answer is: EOB

The correct answer is the Explanation of Benefits (EOB). This document is essential in healthcare billing processes as it provides a comprehensive summary of medical claims. Specifically, it identifies what was billed to the insurance company, what amounts were paid, any instances of rejection or denial of claims, and details regarding claim adjustments. The EOB serves multiple purposes, including informing patients about the coding used for their services, how much the insurance will cover, and the patient's responsibility in terms of any remaining balance. This clarity allows patients to understand their financial obligations and helps them resolve any discrepancies in billing. Understanding the function of the EOB is crucial for navigating healthcare expenses and managing patient accounts effectively, making it an important document in the administrative role within healthcare settings.