After the settlement of the claim from the payer, the claim is either paid or denied and an electronic document known as the Explanation of Benefits (EOB) issued to the healthcare provider.

EOB is provided by the insurer to communicate the determination of the claims processed. The outcome of determination can be a payment or a denial. EOB normally contains information including, patients’ names, their account numbers, control numbers, service dates, procedure codes, billed/allowed/adjusted amounts, denials information, deductibles, sco-insurances, co-payments if any.

When the insurer pays the full amount, the amount billed to the patient becomes zero. If a part amount is paid, the balance payment reflects in the patient’s account.