What does the term "explanation of benefits" (EOB) represent?

The term "explanation of benefits" (EOB) refers to a document that is issued by an insurance provider to policyholders after they receive medical services. It provides a clear summary of the medical care received, detailing the services that were covered under the insurance plan, the amount charged by the healthcare provider, the insurance company's payment, and the remaining balance that the patient is responsible for paying.

This document helps policyholders understand how their benefits are applied, what costs are covered, and what they will need to pay out of pocket. It's an essential part of the healthcare reimbursement process, ensuring transparency between the insurer and the insured.

While other options describe documents or notices related to insurance, they do not capture the specific role of an EOB. For instance, statements about the amount due for coverage or notices about policy cancellation serve different purposes and do not provide the detailed breakdown of services and costs that the EOB offers. Similarly, a summary of the insurance provider's profit does not relate to the individual policyholder’s interaction with their coverage or claims. Thus, the correct definition aligns primarily with the role and content of an EOB in the context of healthcare services and insurance.