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Explanation of Benefits

True Explanation

Understanding your Explanation of Benefits (EOB) is helpful in understanding how your insurance works.

Why do we send you an EOB? It’s an informational statement for your records detailing how your healthcare services processed through your True Health New Mexico insurance coverage.

When you get health care, the doctor, facility, or hospital requests us to pay for those services they provided by submitting a claim. After we process that claim, you will be sent an EOB. This document is a statement that says, “This is not a bill.”

The EOB details the costs associated with the services you received, including:

  • What was billed by the provider or facility you visited
  • Any discounts applied by True Health New Mexico
  • What we paid for your service
  • Total amount covered through your insurance plan
  • What your portion to pay is, based on your insurance coverage

Wondering about your prescriptions? Your prescription claims will not generate an EOB.

Online access: Looking for an electronic version of your EOB? You can access your EOB from the True Health New Mexico member portal.

Frequently Asked Questions about EOBs

Q: “I’m accessing my EOB through the member portal. Can you stop mailing my paper EOBs?”

A: At this time, we are unable to stop mailing EOBs. We plan to have a paperless option available in the near future.

Q: “Why does it take so long to receive my EOB?”

A: Statements go out on a four-week schedule. You can retrieve information about a claim before your EOB is ready in your member portal. After you log in to the portal, go to the Claims section.