Explanation of Benefits (EOB) Details

If you are enrolled in the State and School Employees' Health Insurance Plan, you will receive consolidated EOBs on a monthly cycle, unless you have selected the online explanation of benefits. Online explanations of benefits are available the day after the claim is processed. Be sure to register on myBlue.

The text shown below is the text that appears on your EOB and the interactive EOB sample. Click here to view an interactive demo on reading your EOB form.

1. Patient: All covered family members whose claims process in the same time frame will be printed on the same EOB and grouped by patient name.
2. Type of Service: This column lists the code(s) for each service rendered pertaining to this claim. These codes are explained below the column.
3. Charge: This column lists the total amount charged by the provider for each service.
4. Ineligible (Amount / Code): This column lists any amount ineligible for benefits, such as amounts that exceed our allowable charge, and the amount for services that are not covered. AHS network providers have agreed not to charge State Health Plan participants the amounts over our allowable charge. The code next to each amount is explained immediately below the column.
5. Deductible Applied: This is the amount of the provider's charge applied toward the patient's individual calendar year deductible.
6. Co-ins/Copay: This column shows the amount of co-insurance and/or copay that is your responsibility. If you have other insurance, your other insurance may pay toward this amount.
7. Paid by Other Ins.: If the patient has other insurance that has paid for these services, that amount is shown here.
8. Total Benefit Paid: This is the total Blue Cross & Blue Shield of Mississippi paid for the services noted on this EOB.
9. What You Owe to the Provider: This is the amount that you owe the provider for any deductible, co-insurance, copay and non-covered services. You may have paid some of this at the time the services were provided.
10. Front & Back: Claims information will be printed on both sides of the page(s).

Viewing this interactive EOB requires the Flash player. If you do not have the Flash player, click here to download the free player.