Understanding Insurance Plans: Explanation of Benefits and

Terra Carlson Understanding Various Types of Insurance Plans An Explanation of Benefits is a statement describing what costs were covered by your insurance provider and products you may receive. This comes from your provider who then submits a claim for the services provided. A Remittance Advice is basically proof of payment of "goodwill". Meaning that this document is sent to a buyer (patient) and the seller (provider/insurance) sends this document as a gesture showing what was paid off or for. Examples: For an explanation of benefits, this would be something like looking at what you'd receive for your cable services. This shows what you pay, any "freebees", what you pay gets you, such as channels, internet, Wi-Fi, landland, long distance calling ect. This is similar. Now, when showing examples of remittance advice, this would be kind of like a buy one get one deal. Your receipt will show what you paid for one item then the price for the "get one" portion. This is like your "freebee" or gesture of goodwill. Other Examples: If I as the patient was getting services from my provider and I have insurance, an explanation of benefit would show me all of what services and procedures I had done, and what my insurance covered and the remaining balances I'm left to pay or no balance at all. With a remittance advice, in this same situation, it would be a document showing me costs that were covered in good will.