Question

The document the fiscal agent sends to the provider and/or beneficiary showing the services received, including the TRICARE payment and cost-share amount, is known as:

a) Explanation of Benefits (EOB)
b) Certificate of Coverage (COC)
c) Authorization for Release of Information (ROI)
d) Notice of Privacy Practices (NPP)

Answer 1

The document detailing services received and including TRICARE payments and cost-share amounts is known as an Explanation of Benefits (EOB).

Step-by-step explanation:

The document the fiscal agent sends to the provider and/or beneficiary showing the services received, including the TRICARE payment and cost-share amount, is known as an Explanation of Benefits (EOB). An EOB is not a bill but a statement that provides details of the charges for healthcare services received, the amount covered by insurance, including TRICARE, and what portion of the cost is the responsibility of the insured, often referred to as the cost-share or copayment. The other options listed, such as Certificate of Coverage (COC), Authorization for Release of Information (ROI), and Notice of Privacy Practices (NPP), serve different purposes within healthcare and insurance contexts and do not match the description provided for the document in question.