After each session, your insurance provider may send you an Explanation of Benefits (EOB). While it might look like a bill, it’s not a bill. Instead, it outlines important details about the costs associated with your care.
This guide will help you understand the purpose of an EOB, how to read it, and what it means for your out-of-pocket expenses.
Key Points
An EOB is not a bill; it outlines the services received and costs.
EOBs help you verify services and costs and spot potential errors.
You should check your EOB for accuracy and save it for future reference.
Grow Therapy charge rates listed on the EOB are not the actual amount you owe; your share is typically a copay, coinsurance, or deductible.
Frequently asked questions
What is an EOB?
An EOB is a statement from your health insurance company that explains how they processed a claim for services you received. It’s designed to provide insight into:
The total cost of the care you received.
The amount your insurance plan covers.
The amount you may owe after insurance payment.
✅ Why are EOBs important? EOBs serve several important purposes, including:
Verification: You can confirm that the services listed were actually provided and that the charges are accurate.
Cost clarification: It helps you understand how much of the cost was covered by your insurance and how much remains your responsibility.
Error detection: By reviewing your EOB, you can identify any mistakes in billing or personal information so they can be corrected promptly.
Financial planning: It helps you calculate how much you might need to set aside for upcoming costs, like copays or deductible payments.
How is a claim processed?
After each session, a claim is sent to your insurance provider for processing, which results in an EOB issuance. Here's what the process looks like:
Claim submission: Grow Therapy submits a claim with a charge rate (usually between $180 and $350).
Insurance processing: Your insurance company reviews the claim and determines how much it will cover. This process usually takes about 3–4 weeks.
EOB issued: Once the claim is processed, both you and Grow Therapy will receive an Explanation of Benefits (EOB) outlining the amount you may owe.
🧾 Example: If your session was billed at $162 and your insurance covers $122, you would be responsible for the remaining $40 (your copay, coinsurance, or deductible). Grow Therapy will then charge this amount to the card you have on file.
This guide has more details about insurance coverage and how claims are handled.
Where do I get my EOB?
EOBs are sent directly by your insurance company — Grow Therapy doesn't generate or distribute them. You can typically access yours in one of these ways:
Your insurer's online portal or app: Most insurance companies post EOBs to your member account within a few weeks of a claim being processed.
By mail: Depending on your plan's settings, your insurer may also mail a paper copy to the address they have on file.
By calling your insurer: If you haven't received an EOB for a recent session, call the member services number on the back of your insurance card and ask them to confirm whether the claim has been processed.
Keep in mind that claims typically take 3–4 weeks to process, so it's normal not to receive an EOB immediately after your session.
How do I read my EOB?
Receiving EOBs can feel overwhelming, but understanding the sections can make things clearer. Here’s a breakdown of what you’ll typically find:
Patient information: This section confirms that the services listed are for you.
Provider information: This section identifies the healthcare provider or facility that provided the service, such as Grow Therapy or your therapist’s office.
Service description: This section outlines the services you received (e.g., a therapy session, screenings, etc.), along with any relevant codes associated with those services.
Provider charge(s): This is the amount billed by the provider for your session or service. This charge is typically the highest number you’ll see in your EOB. However, remember that this is not the amount you will owe!
Allowed charge(s) member rate: This is the negotiated rate between your insurance company and the provider. It’s typically lower than the billed amount and is used to determine how much your insurance will pay.
Plan's share: This shows the amount your insurance will cover. This amount is paid directly to the provider and reduces your out-of-pocket costs.
Your share: This is the amount you owe after your insurance has paid its share. This may include your copay, coinsurance, or part of your deductible. If you’ve already made a payment to the provider, it may not yet appear on this EOB.
Amount not covered: This section includes the portion of the charge not paid by insurance. This could be due to deductibles, copays, coinsurance, or services not covered under your plan.
Remark code: Remark codes provide explanations for certain charges, such as why a service wasn’t covered (e.g., “not medically necessary” or “out-of-network service”).
💰Why is the billed (provider charges) amount so large? It’s common to see a high billed amount on your EOB—but don’t panic! That’s not the amount you owe.
The billed amount: This is the full price that Grow Therapy charged for your services.
What you owe: After your insurance processes the claim, you’ll only be responsible for "your share" amount, which could be your copay, coinsurance, or portion of your deductible.
What do I do with my EOB?
After receiving an EOB, you should:
Double-check the information: Verify that all details are correct, including your name, the services listed, and the associated charges.
Contact insurance for clarification: Request more details if something seems incorrect, such as unfamiliar charges or inaccurate coverage.
File or save it: EOBs are important records. Keep them for future reference, or if you need to follow up with your insurance company or provider.
How much do I owe?
Once your insurance company processes the claim, your EOB will show the amount you're responsible for. You may be charged for any of the following:
Copay: A fixed amount you pay for each session.
Coinsurance: A percentage of the total cost that you are responsible for.
Deductible: The amount you must pay out-of-pocket before your insurance begins to cover costs. Once your deductible is met, you’ll typically only pay a copay or coinsurance until you reach your out-of-pocket maximum.
This video by Kaiser gives a great overview. Remember that if you have a deductible-based plan that restarts at the beginning of the year, you may be charged the full member rate until you reach your deductible.
Why does my EOB say my provider is out-of-network?
Seeing "out-of-network" or "non-participating provider" on an EOB can be alarming, especially if you searched for in-network providers when you booked. A few things can cause this:
Credentialing lag: There's often a delay between when a provider joins Grow Therapy's network and when your insurance updates their records to reflect that. Claims submitted during this window may initially be processed as out-of-network, even if the provider is in-network.
Plan-specific networks: Some insurance plans have tiered networks, meaning a provider may be in-network for one plan but not another offered by the same insurer.
Retroactive credentialing: In many cases, once the credentialing is complete, your insurer can reprocess the claim and apply in-network rates retroactively.
If your EOB shows out-of-network for a provider you found through Grow Therapy's search, contact our support team — we can look into the credentialing status and help get the claim reprocessed if needed.
Why is the amount on my EOB higher than what I was quoted?
Cost estimates provided before your session are based on the insurance information on file at the time of booking and are estimates—not guarantees. A few common reasons the final amount may differ:
Deductible resets: If your deductible reset at the start of a new plan year and hasn't been met yet, you'll be responsible for the full member rate until it is.
Insurance information changed: If your plan, coverage tier, or policy number changed between when you booked and when the claim was processed, your cost-sharing may have changed too.
Estimate limitations: Cost estimators calculate based on your reported plan details, but can't account for all plan-specific variables, like whether your plan covers telehealth at the same rate as in-person care.
If the amount differs significantly from what you expected and you believe there may be an error, you can contact our support team or your insurance provider directly to request a detailed explanation.