Which document explains to the patient what the insurer paid and what remains due after processing a claim?

• A. Explanation of benefits
• B. Encounter
• C. Co-payment
• D. Procedure number

Answer: (A)

The main idea here is understanding how a patient sees the financial result of a processed claim. The document that explains exactly what the insurer paid and what remains due is the Explanation of Benefits. It shows the billed charges, the allowed amount, the insurer’s payment, any adjustments, and the patient’s remaining responsibility (such as deductible, coinsurance, or copays). This helps the patient know how much they still owe to the dental office. It’s not a bill itself; a separate bill from the provider may itemize any remaining balance. In contrast, an encounter is the clinical record of the visit, a co-payment is the amount paid at the time of service, and a procedure number is simply a code identifying the service.