Explanation of benefits
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Search complete. 35 mentions across 14 episodes found for "Explanation of benefits".
Oct 5, 2026
Amber Weber GonzalezHOST
Mm.
Sam RockwoodGUEST
And then the other thing was offices would tell me, "Well, I don't like hunting for the EOB when I get paid electronically." They like that the EOB comes in the mail with the check, and so that they're like, "Well, we're just gonna keep doing that." And so, uh, that's where Woods came about, was like, okay, we can take over the enrollment process for you.
Sam RockwoodGUEST
We, in our enrollment, in our onboarding with us, we get the basic info needed so that we can do the enrollment for you and get your signatures and permission to do that.
Sam RockwoodGUEST
And then our dashboard brings all the EOBs in- into one place so that you don't have to go hunting them down on all the different websites.
Sam RockwoodGUEST
So really just looking for ways to knock down the, the friction of getting to EFT.
Courtney StaigerHOST
So-
Sam RockwoodGUEST
And then what I've heard for EFT fraud is that it typically is when an office member will go and change the bank account to have it routed to their own [laughs].
Sam RockwoodGUEST
And the way we prevent that is our dashboard ties to your bank account, and we basically check off every time that a, a transaction is deposited.
David HarrisHOST
What your staff get is, um, has various names.
David HarrisHOST
We normally refer to it as an explanation of benefits or EOB.
David HarrisHOST
So a piece of paper comes into your practice from the insurance company that says, "Here's how much we paid What your staff do next is they take that EOB form, and they use that to enter the payment information into your practice management software.
David HarrisHOST
So if the EOB says that $812 was paid for a specific patient, then that amount will get entered or posted into your practice management software.
David HarrisHOST
The problem with this is that the money gets deposited, but your staff typically don't have access to your bank account, so they're kind of taking it on faith or they're, they're taking that EOB at face value that says the money went into your bank account.
David HarrisHOST
We have seen numerous examples, and I'm gonna show you an, an outrageous one in a minute, where money that was supposed to go into this practice went somewhere else.
David HarrisHOST
And the other thing that I would change if I could is that the majority of practice owners don't do the comparison between collections and deposits, a- and between what their practice management software says they collected and what went in their bank, which means that if money is going sideways somewhere, um, it might not get noticed.
Ann Marie CarrollSOUNDBITE_SPEAKER
It went on for four and a half years.
David SimsHOST
But, you know, like you had the same thing I do.
David SimsHOST
So you never download EOBs, you never download PDFs, you're never downloading any information from the HR.
David SimsHOST
Well, yeah, sometimes.
David SimsHOST
Okay then.
Caleb HerndonGUEST
There's a claim that incurs.
Caleb HerndonGUEST
So when that happens, right, you go through the hospital, you're probably assigned some medication, and then you're dealing with bills and, and EOBs and stuff on the back end, right? So there's, there's money to be made there.
Caleb HerndonGUEST
So all three players have their hand in the pie, right? And so when we look at it from a micro standpoint, these big insurance and, and healthcare and pharmacy companies, you know, when they look at who their loyalties are to, they're to their stakeholders.
Caleb HerndonGUEST
Most of them, not all of them, most of them are publicly traded companies.
Susan HudsonHOST
A lot of times you still have a copay where you have to pay a certain percentage.
Susan HudsonHOST
And there's also the wonderful, heartbreaking, stressful event of getting what's called an EOB.
Susan HudsonHOST
An EOB stands for Explanation of Benefits.
Susan HudsonHOST
The biggest thing that we probably order that causes the biggest heart attack is carrier screening.
Carrie BedientHOST
Always.
Bill DavisHOST
Absolutely.
Bill DavisHOST
Because I think I've told you before, after all of that, my EOB explanation of benefits probably has exceeded a million dollars, don't you think?
Phil GeorgeHOST
Yeah, easily.
Phil GeorgeHOST
And I
Krista DiBiaseHOST
"This experience was a real wake-up call for me.
Krista DiBiaseHOST
Read your EOBs and compare the patient responsibility amount with what you actually paid.
Krista DiBiaseHOST
If the EOB shows you paid more than your responsibility, follow up immediately."
Clark HowardHOST
Robert, thank you very much.
Clark HowardHOST
If you are fortunate enough like you are that you have health insurance, you need to cross-reference what they tell you your share is and then what shows up on the EOB, just like you did.
Clark HowardHOST
And just because you did that, you've got more than $500 back in your pocket.
Clark HowardHOST
I hope that you taking the time to share your story, Robert, will inspire others to do the same, to take that time and review the EOBs when they come in.
Clark HowardHOST
I know they're confusing, so you gotta sit there, and I look at them page by page, and they keep trying to get me to go to paperless.
Joe SweeneyGUEST
It could be as simple as, hey, I'm looking for a provider for a particular service.
Joe SweeneyGUEST
It can be, hey, I got this EOB and this explanation of benefits, EOB in the mail.
Joe SweeneyGUEST
And it says I owe some money.
Joe SweeneyGUEST
It doesn't make any sense.
JeffreyHOST
It's so fucking stupid.
KatrinaHOST
I got an email yesterday saying that I had a new EOB, which is something, Explanation of Benefits.
KatrinaHOST
And I've taken to not looking at them recently because everything's like, you owe money, you owe money, you owe money.
KatrinaHOST
And it's like, well, bitch, I don't know where you would like me to get this money from, but...
JeffreyHOST
before but again okay so uh
KatrinaHOST
i got an eob email and i was like fuck let me see because i'm waiting for the um i'm waiting for the clearance of the radiation and um my chemo pills.
KatrinaHOST
And I didn't know what EOB that would, that was.
KatrinaHOST
So I click on it and it was like, oh, your, uh, chemo pills have been approved.
Dave SyversonGUEST
And carriers ought to be doing a better job of talking about the problem as well.
Dave SyversonGUEST
You're mailing out EOBs to these people every single week.
Dave SyversonGUEST
You have an envelope or an email that you can easily put information in there to help educate people, and carriers just don't take advantage of that.
Jeff KeicherGUEST
Yeah, and one of the ideas that we kicked around, somewhat jokingly, but I think there's good underlying, is if we focus back on these defrayal issues, what if every policy renewal included a breakdown of what the added costs are in your monthly premium because of Band-Aids that were forced upon you at the state level? where a legislator knows that they're going to be held out to increasing everybody's premium by this many dollars.
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