What happens after my claim is processed?

Once your insurance company reviews and processes the claim ( “adjudication”), they’ll issue an Explanation of Benefits. This is not a bill. It shows:

• What was covered
• What is charge amount allowed (or disallowed)
• What they applied to your applicable deductible if still unmet
• What they paid based on your coinsurance rate (if any)
• What your remaining responsibility is to your provider from their point of view (e.g. had you not already paid for services upfront)