Understanding Los Angeles Anthem Explanation of Benefits (EOB)

As an informed consumer, it is important to understand how your health insurance coverage is being applied to each specific claim that is filed under your policy. Understanding Los Angeles Anthem Explanation of Benefits (EOB) is the first step to determining whether your medical claim is being processed and covered as it should. Insurance companies have made changes to EOBs over the last several years to make them easier to understand.

When these documents are easier to follow and understand, consumers can catch mistakes or research their claims without having to be an expert in the insurance field. If based on your EOB, you believe that one of your health insurance claims was improperly processed or denied, an experienced insurance lawyer can work with you to appeal the denial.

What is an EOB?

Insurance companies, including Anthem, are required to provide claimants with written documentation about their claim within 30 days of service. For those insured by Anthem, the documentation is known as an Explanation of Benefits (EOB) and can be uploaded to a website, emailed, or sent to the insured via USPS. It is important that people understand that an EOB is not a bill, it is a reference for the insured. If, after reviewing the EOB a patient does not have questions and believes the claim was processed as it should have been, no further action is needed.

However, if the patient is having a difficult time understanding their Los Angeles Anthem Explanation of Benefits (EOB), they should contact Anthem for further explanation. If the patient believes that something is wrong or has been processed incorrectly, they may want to consult with an insurance attorney to determine what actions they can take and what their rights are.

Different Parts of Anthem’s Explanation of Benefits

An EOB contains several different pieces of information in order to help patients fully understand how their claim was covered. Common pieces of information that can be found on an EOB for Anthem include:

  • Provider charges – the amount the medical provider billed Anthem for a medical service
  • Payee – the party that will get any reimbursement if the claim has been overpaid
  • Allowed charges – the amount that the insurance company has agreed to pay the provider for their medical services
  • Paid by insurer – the amount that Anthem paid to the provider
  • What the patient owes after Anthem has paid their portion
  • Remark Code – explains in more detail about the costs, charges, and amounts paid for a medical claim

How a Los Angeles Anthem Attorney Can Help with Understanding the Explanation of Benefits (EOB)

Even though they are meant to help EOBs can still be confusing. If you need help understanding Los Angeles Anthem explanation of benefits (EOB)s or believe that your claim has been denied without merit, an experienced insurance attorney can help you.

An attorney who is well-versed in reading and understanding EOBs can work with Anthem to get your claims paid. You deserve help and a skilled attorney can give you the assistance you need. Call today to set up a consultation.