employer connection

Explanation of Benefits

We asked our members and producers what they thought about our Explanation of Benefits (EOB) statement and then we redesigned it to better meet our members' needs.

Our new EOB statement is easier to use and gives our members more information about their plans.

More Features

Not only is our new EOB clearer and more informative about claims processing and benefits, but it also offers more customer-friendly features like:

  • Ease and simplicity of benefits explanation
  • Explains financial costs with improved accuracy
  • Reinforces the value of utilizing a Blue Shield network provider
  • Details the time it took Blue Shield to process a claim

Taking the Lead

We think our redesigned EOB is now the "best-in-class" in the industry with many noteworthy changes like:

  • Plain English explanation of why the member is receiving the EOB
  • Prominently displayed patient responsibility amount (clearly answers a member's question, "What do I owe?")
  • Provides members with an explanation of the details related to the processing of the claim
  • Easy-to-read detail grid (clarifies amount allowed versus amount billed)
  • Explanations on an amount allowed versus amount billed
  • Claim Summary at a Glance box which:
    • Prominently displays patient responsibility amount and deductible status
    • Summarizes the most important information from the customer standpoint
    • Contains Network Savings that highlight the value provided by Blue Shield
  • Helpful definitions on the back of the EOB
  • Tells members how quickly their claim was processed by Blue Shield
  • Larger font
  • Elimination of ALL-CAPITALIZED notes and messages

See the Difference

Download and view a sample EOB (PDF, 153KB) to see the many improvements we've made.