Insurance term
EOB (Explanation of Benefits)
Definition
An EOB is a statement from the insurance payer that explains how a claim was processed: what was billed, allowed, paid, adjusted and left for the patient.
Why it matters for the front desk
The EOB is the source for posting payments, writing off contractual adjustments and billing the patient's balance. It also carries the reason codes that explain denials and partial payments, which is where follow-up starts. Patients receive their own copy and often call with questions, so the team should be able to read one line by line. A secondary claim usually requires the primary plan's EOB.
Related reading
Blog
Manual vs Automated: What Insurance Work Really Costs Your Front Desk
Related terms
- ERA (Electronic Remittance Advice) An ERA is the electronic version of an explanation of benefits, sent by the payer in the standard X12 835 format.
- Coordination of Benefits Coordination of benefits (COB) is the set of rules that decides which plan pays first, and how much the second plan pays, when a patient has two dental plans.
- Clearinghouse A clearinghouse is a company that passes electronic claims, eligibility checks and payment information between a dental practice and insurance payers.