Understanding Your Explanation of Benefits (EOB)

Your Explanation of Benefits (EOB) lets you know when and how your claims are processed by Blue Cross and Blue Shield of Texas. It isn’t a bill. It gives you a detailed look at the covered services and shows how much you may owe your provider after your benefits have been applied.

EOBs include confirmation of your policy ID, helpful contacts and a glossary of terms. It also provides the following information:

• Covered patient
• Provider (doctor, hospital, lab or other provider)
• How your benefits are applied (amount billed, amount covered and health plan responsibility)
• Your responsibility including any deductible, copays and coinsurance

Your Benefits Applied – This section shows your list of services and how they’re covered.

• Amount Billed is the total amount your provider billed for the services.
• Amount Covered (Allowed) is the amount billed (G) minus any discounts or reductions (H).
• Health Plan Responsibility is the portion the plan paid to the provider.
• Your Total Costs is the sum of your copay, deductible and coinsurance. You may owe less if your provider collected any of these payments before beginning services. It also includes any amounts not covered by your health plan. The total cost in this column details the amount shown in the claim summary. It does not include any amounts that a non-participating provider may bill you.

Save a copy of this EOB explanation flyer for your records!

You may sign-up to receive your EOBs online at Blue Access for Members^SM by logging in at bcbstx.com or Text* GOBCBSTX to 33633 to download the mobile app.

* Message and data rates may apply. See terms and conditions and our privacy policy at bcbstx.com/mobile/text-messaging. Source: BCBSTX