Understanding your Explanation of Benefits
HealthPartners typically provides you with an Explanation of Benefits (EOB) for health care services so that you can understand how we plan to process your claims.
To help you better understand your Explanation of Benefits, match the number in the the list with the numbers in the text fields. Each number is associated with the field description.
*EOBs may print in different format based on the original EOB print date.
- Date EOB was generated
- Patient's name
- Patient's member number
- Subscriber/owner of policy (not necessarily patient)
- Employer's group number and policy name
- Claim reference number
- Provider of care
- Patient control number
- Date claim was received
- Check number
- Date of check
- Check issued to
- Dates of patient care
- Description of care
- Total charges
- Provider's responsibility
- Amount member owes + amount paid by HealthPartners
- Member's cost based on co-pay
- Member's cost based on deductible
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- Member's cost based on co-insurance
- Amount of services not covered by insurance
- Reference to notes (#33) on non-covered amounts
- Amount paid by HealthPartners
- Amount member owes
- *Individual out-of-network out-of-pocket balance
- Individual in-network out-of-pocket balance
- *Individual out-of-network deductible
- Amount paid by patient's other benefit plan
- Tax paid by provider
- Total plan covered amount payable to policyholder
- Total plan covered amount payable to provider
- Total member liability – what you owe
- Explanation of any non-covered amounts
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*If plan allows member to combine in and out-of-network charges together the out-of-network amount will be reduced by any in-network charges.
