Question

instructions: select the most appropriate response.
which is sent by the third - party payer to the patient and details the results of processing a claim?
○ a. remittance advice
○ b. appeal letter
○ c. explanation of benefits
○ d. premium statement

Explanation:

• A remittance advice is sent by the payer to the provider, not the patient.
• An appeal letter is sent by the patient or provider to contest a claim decision, not by the payer to detail claim processing.
• A premium statement details insurance premiums owed, not claim processing results.
• An explanation of benefits (EOB) is sent by the third - party payer to the patient. It details how the claim was processed, including covered amounts, patient responsibility, etc.

Answer:

c. explanation of benefits