Скачать или смотреть How to Read an Explanation of Benefits (EOB) & Electronic Remittance Advice (ERA) in US Healthcare

Have you ever struggled with understanding an Explanation of Benefits (EOB) or the Electronic Remittance Advice (ERA)? If so, today’s video is for you! We're breaking down real-life examples of claim processing, so you can confidently interpret when an insurance company is processing a claim toward the deductible versus outright denying a claim.

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💡 In This Video, You’ll Learn:
✔️ The difference between a denial and a claim applied to a deductible
✔️ How to read insurance EOBs and ERAs from different clearinghouses
✔️ What key codes (like PR1 and CO-45) mean for patient responsibility
✔️ How to determine what the patient actually owes after insurance processing
✔️ Why the allowed amount is different from your billed charges
✔️ How to verify that a claim has been processed correctly

📌 Key Takeaways:

A zero payment from insurance doesn’t always mean denial—it may mean the claim was applied toward the deductible.
PR1 = Patient Responsibility for Deductible → The patient owes this amount.
CO-45 = Contractual Obligation → The practice must write off this amount and cannot bill the patient.
Always cross-check your EOB/ERA formats, as different software systems display the same information differently.
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