While both EOBs and ERAs provide similar information about patient claims and payment, the key difference lies in their format.
EOBs are traditionally paper documents mailed to patients, whereas ERAs are electronic documents intended for providers. An ERA typically provides more detailed information than an EOB, including codes for procedures and diagnoses, payment details, patient responsibility amounts, adjustments, denial reasons, etc.
EOB (Explanation of Benefits)
An EOB is a document sent by an insurance company to their beneficiaries explaining what services were provided, how much the insurance company will cover, and what the patient's responsibility is in terms of payment. It provides a detailed breakdown of the costs associated with a specific service or procedure.
EOB Example
ERA (Electronic Remittance Advice)
An ERA is an electronic version of a payment explanation which provides details about providers' claims payment, and if the claims are denied, it shows the reasons for the denial. ERAs are essentially digital versions of EOBs and are intended to simplify the process of managing claims for healthcare providers.
ERA Example
