Question

When a payment is due for an approved claim, the payer sends which of the following to the provider along with the payment?

a) EOB (Explanation of Benefits)
b) HIPAA (Health Insurance Portability and Accountability Act)
c) ICD-10 (International Classification of Diseases, 10th Edition)
d) HMO (Health Maintenance Organization)

Answer 1

The payer sends the Explanation of Benefits (EOB) to the provider along with the payment for an approved claim.

Step-by-step explanation:

When a payment is due for an approved claim, the payer sends the Explanation of Benefits (EOB) to the provider along with the payment. The EOB is a document that explains the details of the claim and how the payment was calculated. It provides information such as the services rendered, the amount billed, the amount covered by insurance, and any remaining balance to be paid by the patient.