What is sent by the third-party payer to the patient detailing the results of processing a claim?

The term relating to the document that a third-party payer sends to the patient, explaining the results of processing a claim, is the Explanation of Benefits (EOB). This document serves multiple purposes: it outlines the services provided, the amount billed, the amount covered by the insurance, the patient's financial responsibility, and any adjustments made by the insurance company.

The EOB is essential for patients as it provides transparency regarding their healthcare expenses and ensures they understand how their claims were processed. It informs the patient of what was paid, what is still owed, and any reasons for denial or adjustment in claims. This level of communication helps maintain a clear understanding between the patient and the insurer regarding payment responsibilities.

The other options do not accurately fulfill this function. An appeal letter is typically a request to reconsider a denied claim, a remittance advice is sent to healthcare providers detailing payments made, and a premium statement summarizes the insurance premium payments rather than claim processing results.