Final answer:
The document detailing services and charges related to health insurance coverage is known as an Explanation of Benefits (EOB). It includes information about services provided, costs, deductibles, copay amounts, coinsurance, and the division of financial responsibility between the insurer and the subscriber.
Step-by-step explanation:
The document sent by insurance companies to a subscriber detailing the services and charges submitted for payment by the medical office is called an Explanation of Benefits (EOB). An EOB typically includes the type of medical services received, the cost of those services, the deductible amount, copays, any coinsurance required, the amount paid by the insurer, and the amount due from the subscriber. The EOB acts as a statement that breaks down the financial aspects of a health care service claim, and it allows the subscriber to see what part of the service is covered by insurance and what part must be covered out-of-pocket.
Deductibles are the amount the policyholder must pay before the insurance begins to cover costs, reducing moral hazard by ensuring some cost-sharing from the insured party. Health insurance plans, including Health Maintenance Organizations (HMOs) and fee-for-service arrangements, use such methods to manage their payouts and encourage mindful usage of health care services.