Final answer:
The document a patient receives from an insurance company detailing claim payment information is called an Explanation of Benefits (EOB). This document outlines the financial responsibilities of the patient, including deductibles, copayments, and coinsurance, based on their insurance policy's coverage.
Step-by-step explanation:
The notice sent by the insurance company containing payment information about a claim is typically referred to as an Explanation of Benefits (EOB). An EOB details the amount billed by the provider, the amount covered by the insurance, any deductibles, copayments, or coinsurance that the patient is responsible for, and the final amount paid by the insurance to the provider. It is crucial for patients and providers alike to understand this document, as it explains the payments and cost-sharing responsibilities under the terms of an insurance policy.
In the context of health insurance, the deductible is the out-of-pocket amount the policyholder must pay before insurance benefits kick in. This, alongside copayments and coinsurance, is designed to prevent moral hazard by ensuring that policyholders have a financial stake in the cost of their healthcare services. Understanding the fee-for-service system and health maintenance organizations (HMOs) can also help in comprehending how providers get reimbursed and the impact of differing insurance policy structures on overall healthcare costs.