Question

What term: the insurance company pays the claim directly to the patient and sends you this

a) Explanation of Benefits (EOB)
b) Health Maintenance Organization (HMO)
c) Preferred Provider Organization (PPO)
d) Point of Service (POS)

Answer 1

The term when the insurance company pays the claim directly to the patient and provides details about that payment is known as an Explanation of Benefits (EOB).

Step-by-step explanation:

The term that refers to the insurance company paying the claim directly to the patient and then sending an explanation of that payment is known as an Explanation of Benefits (EOB). The EOB is a statement from the insurance company detailing what costs were covered, the amount paid to the healthcare provider or patient, and what the patient may still owe, such as a deductible or copayment. It is not considered a bill but is an important document for patients to understand the services they received and the coverages applied by their health plan.