After you visit a doctor, clinic or hospital, you will get a statement from Blue Cross and Blue Shield of Texas (BCBSTX) that explains what was covered under your plan. This is called an Explanation of Benefits, or EOB.
Your EOBs have a fresh new look to make them easier to read and understand. We have updated the design and simplified the math and language to help you better understand your health care spending.
The new full-color layout was user-tested and has three main sections:
- Total of Claim(s) features the main financial information about your claims. It includes totals for the amount billed, benefits approved and the amount you may owe the provider. Sometimes one EOB may contain more than one claim.
- Service Detail for each claim describes each service you or your dependent received, the facility or physician, the dates, and the charges. It also shows the savings your BCBSTX benefits plan provides for you from provider discounts and other deductions. You can also see amounts that may not be covered.
- Summary gives you a clear picture of each claim’s deductible, coinsurance, copays and health spending accounts, if applicable.
The new EOB will also reduce paper — most claims will fit on one page. The appeals notifications that go with the EOBs are also streamlined. The new EOB is also available in Spanish.
Questions About Your New EOB?
You can send us a secure message through the Message Center in Blue Access for MembersSM. Or you can call the customer service number on the back of your member ID card. Be sure to have your member ID number and EOB ready when you call.