What is the term for the statement issued by the payer to the insured explaining services provided and payments made?

The term that best describes the statement issued by the payer to the insured, detailing the services provided and the payments made, is "Explanation of Benefits" (EOB). An EOB serves multiple purposes. It outlines the healthcare services that were rendered, specifies the amounts billed by the provider, indicates what amounts were covered by the insurance, and details any patient responsibilities, such as copayments or deductibles.

The EOB is crucial for transparency in healthcare billing, helping patients understand their financial obligations and allowing them to track the processing of their claims. This document is essential for ensuring that patients are aware of the insurance payments and what they owe to their providers, thus facilitating effective communication between the payer, the provider, and the insured.

While other terms like claim summary, payment statement, and billing statement might refer to similar aspects of the billing process, they do not encompass the comprehensive reporting of insurance coverage, payment, and patient responsibility that is specifically conveyed in an Explanation of Benefits.