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- • E.O.B. (Explanation of Benefits). This is the statement you will receive from your insurance carrier when
- your claim has been paid. It will show the provider of services, the place of service and how the benefits were
- paid. If you have a deductible or co-insurance, this will also be stated on your E.O.B. If you have a secondary
- insurance carrier, that company will need a copy of your E.O.B. in order to pay its portion.
- • Assignment of Benefits. This is required by most physicians' offices. It means that you want your insurance
- company to send payments directly to the provider of services. Assignment of Benefits is usually signed in
- the physician's office on an office form. There is also a place for your signature on your claim form.
- • Medicare Assignment. Any physician can accept the fee schedule set by Medicare in an individual case. A
- participating provider in the Medicare program has agreed to always take the set fee schedule ("assignment").
- If your physician takes Medicare assignment (fees), you are then responsible only for non-covered services,
- your deductible and your co-insurance. If the physician is not a participating provider in the Medicare
- program, you can be responsible for more than the 20 percent co-insurance. If the physician's charge is more
- than the Medicare allowable charge, for instance, the physician would receive 80 percent of the Medicare
- allowable while you would be responsible for the rest of the bill.
- Make sure you ask ahead of time if your physician participates in the Medicare program and will accept
- assignment of benefits for your care.
- • E.O.M.B. (Explanation of Medicare Benefits). This is sent to you as soon as your claim has been paid. It will
- state the provider of any service, the amount allowed under the Medicare fee schedule, the amount paid and
