What is an EOB (Explanation of Benefits)?

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What is an EOB?

The explanation of benefits (EOB) you receive from your insurance company is not a bill, but rather a reflection of how your insurance processed your claim. An EOB is sent from the insurance carrier and is meant to help you understand how much each service costs, how much your plan will cover, and typically how much you may have to pay when they do receive a bill.

 

EOBs & Headway's claim cycle

Headway’s claim cycle is a bit different because Headway collects the patient responsibility (co-pay, co-insurance, or deductible amount) after your sessions but prior to filing the claim. You are billed by Headway immediately after your provider confirms that the session took place and enters the codes for your session, and those codes determine your cost.  We are able to do this because our system reads insurance benefits in real time, so we’re able to bill at the time of service, instead of waiting for insurance to process claims submitted via Headway. The cost per session is based on each clients’ behavioral health benefit within their specific insurance plan. You can see all prior invoices from Headway on your Past Appointments Page.

Your healthcare providers should charge you the amount listed under “Client Responsibility” on your EOB if the claim is processed correctly in-network. If your claim is denied for any reason, or the EOB indicates that you owe something other than what was charged, let us know so that we can look into further.  

Reasons your EOB might indicate a different cost than your Headway charge include:

  • Insurance company processing error 
  • Out-of-date insurance information 
  • Insurance lookup error
  • Non-covered benefit 
  • Coding error 

If your charges from Headway are different from what is reflected on your EOB, we will investigate the source and refund as needed.

By signing up with your insurance plan and seeking care with an in-network provider, you have agreed with your insurance company to pay the "Client Responsibility" amount on your explanation of benefits.  We aren’t able to alter the costs of sessions, except in very limited circumstances, due to the agreements you and Headway have made with the insurance company. 

 

Additional Support

Since Headway handles all of the billing, claims, and administrative work for our providers, if you ever have any questions about claims, please contact Headway directly. Kindly attach any applicable documents to your inquiry, including:

  • invoices 
  • explanation of benefits (EOB)  
  • front and back photos of your insurance card

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