ASSIGNMENT Explanation of Benefits

Explanation of Benefits or EOB for short is a statement from your health insurance plan describing what costs it will cover for medical care or products youve received. The EOB is generated when your provider submits a claim for the service you received.

For this assignment, please review the EOB cases (see additional attachment) and answer the following EOB questions related to each case. Each case is worth Five (5) points.

Examples:

1. Case 1- CPT code 99204

Charge amount- $250

Allowed amount: $114

Patient co-insurance: $22.80

Insurance amount paid by Insurance: $91.20

Physician write-off: $136..00

Answer the following EOB:

Case 2 - CPT code 99212

A) What is the charge amount?

B) What is the allowed amount?

C) What is the patient co-insurance amount?

D) How much did the insurance paid?

E) Is there a physician write off?

Case 3- CPT code 99213

A) What is the charge amount?

B) What is the allowed amount?

C) What is the patient co-insurance amount?

D) How much did the insurance paid?

E) Is there a physician write off?

Case 4- CPT codes 97110, 97140

A) What is the charge amount?

B) What is the allowed amount?

C) What is the patient co-insurance amount?

D) How much did the insurance paid? E) Is there a physician write off?