Explanation of Benefits (Eob) Request - Texas

Explanation of Benefits (Eob) Request is a legal document that was released by the Texas State Office of Risk Management - a government authority operating within Texas.

FAQ

Q: What is an Explanation of Benefits (EOB)?
A: An Explanation of Benefits (EOB) is a statement provided by a health insurance company that explains the costs and benefits of a healthcare service or procedure.

Q: Why would I need to request an EOB?
A: You may need to request an EOB if you did not receive one from your health insurance company or if you need a copy for your records or to dispute a claim.

Q: Is there a fee to request an EOB?
A: Generally, there is no fee to request an EOB from your health insurance company.

Q: How long does it take to receive an EOB?
A: The time it takes to receive an EOB can vary depending on your health insurance company, but it is typically sent out within a few weeks of a healthcare service or procedure being provided.

Q: What information is included in an EOB?
A: An EOB typically includes details about the healthcare service or procedure, the amount billed by the healthcare provider, the amount covered by your insurance, any out-of-pocket expenses, and a summary of benefits.

Q: Can I dispute an EOB?
A: Yes, if you believe there is an error or discrepancy in your EOB, you can contact your health insurance company to dispute the charges or seek clarification.

Q: What should I do if I don't understand my EOB?
A: If you have questions or don't understand something on your EOB, you can contact your health insurance company's customer service department for assistance.

Q: Do I need to keep my EOBs for my records?
A: It is a good idea to keep your EOBs for your records in case you need to reference them or dispute a claim in the future.