Once you or one of your dependents have visited your physician for an appointment or procedure, the medical office will submit a claim to Health Alliance for payment. The Health Alliance team will determine how much of the service’s cost will be covered by insurance based on your plan, remaining deductibles and out of pocket maximums.  

Health Alliance will then send the Explanation of Benefits, or EOB, document. The EOB shows the following information: 

• Services or procedures that your doctor's office claimed
• Total costs from your doctor's office for those services
• Any discounts that Health Alliance has set up with your doctors
• How much of your deductible applies to those services
• The co-pay or coinsurance you paid for those services
• Any costs that weren't covered by your plan and why they weren't covered
• How much was paid by other insurance plans you might have
• How much Health Alliance paid
• Your Total Member Responsibility, or how much you still have to pay for those services

The EOB document is not a bill, only an explanation of how your insurance coverage was applied. You will receive a separate bill from the medical facility.  

You can view your EOBs on the Claims section on Hally.