Office Administrative Assistant Practice Exam

What is the primary purpose of an EOB?

1. To confirm appointment

2. To explain benefits and payments

3. To request payment from the patient

4. To verify eligibility for services

The correct answer is: To explain benefits and payments

The primary purpose of an Explanation of Benefits (EOB) is to explain benefits and payments. An EOB is a document sent by a health insurance company to inform the insured about how a medical claim has been processed. It outlines the services provided, how much the insurer will pay, the amount billed by the healthcare provider, any deductibles or copays that may be due, and the remaining balance the patient is responsible for. This transparency helps patients understand their coverage and the financial aspects related to their healthcare services. In contrast, confirming appointments, requesting payments from patients, and verifying eligibility for services are functions that can occur in healthcare and insurance contexts but do not specifically relate to the purpose of an EOB. The EOB is focused on communication between the insurer and the insured about claims and payments, rather than administrative actions like appointment scheduling or payment requests.