University of California Health and Insurance Coverage for Residents and Fellows

Explanation of Benefits

What to Know

PPO members: After you visit a provider, you’ll receive an Explanation of Benefits (EOB) from Anthem Blue Cross.

 An EOB provides information about:

  • How your claim was paid
  • The amount you’ll be reimbursed or may still owe

Here are some terms and definitions to know when reviewing your EOB. Visit the glossary page for additional definitions.

Service Date. The date(s) on which you received health care services.

Amount Charged. The amount billed by the provider who performed each service.

Allowable Charges. The price Anthem Blue Cross has approved for that service (includes any deductiblecoinsurance or other amounts for which you are responsible).

Other Amounts Not Covered. A cost that exceeds your benefits or cost for services that aren’t covered. You may be responsible for this amount (plus any deductible, coinsurance or copayment).

Applied to Deductible. An amount that is considered part of your deductible (the amount you must pay for covered health care costs before your benefits are paid). You are responsible for this amount.

Benefit year. The time frame in which the medical plan is effective. The medical benefit plan year runs July 1 through June 30 of each year.

Copayment. The set amount that you pay for benefits. You are responsible for this amount.

Coinsurance. The amount remaining after the plan pays its share of covered services, usually shown as a percentage of negotiated charges. You are responsible for this amount.

Amount Paid. The total amount paid to you or your provider.

Provider Contact Information

Graduate Medical Education Office

Anthem Blue Cross

Group Number: 281636
PPO members: (833) 674-9256, Monday through Friday, 8 a.m. to 8 p.m. PT
HMO members: (833) 674-9257, Monday through Friday, 8 a.m. to 8 p.m. PT
First Impressions (for first-time PPO and HMO plan members): (888) 831-2238
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