What is EOB (Explanation of Benefits)?
A human-readable statement of how a claim was adjudicated — the paper counterpart to an ERA/835.
Definition
An explanation of benefits is the readable document explaining what a payer allowed, paid, adjusted, and assigned to the patient. Patients receive an EOB describing their own liability; providers receive a provider remittance advice that serves the same purpose across a batch of claims.
The practical distinction from an ERA is machine-readability, not content. An EOB has to be read and keyed by a person; an ERA can be posted automatically and aggregated into denial and payer-performance reporting. A practice working from EOBs is doing by hand what an 835 does in seconds, and is generally unable to answer questions like "which payer denies the most, and for what" at all.
Why it matters
Payers still on paper EOBs are the ones whose denial patterns nobody can see. Getting every payer onto ERA is usually the single highest-return administrative project in a small billing operation.
Related terms
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