Understanding Your Explanation of Benefits (EOB)

An Explanation of Benefits (EOB) is a statement from your insurer—not a bill—that shows how your claim was processed. It explains the submitted charge, what the insurer paid, and what you may owe.

Key parts of an EOB

Provider charge: The amount billed by the provider.

Allowed amount: The negotiated rate your insurer recognizes.

Insurance payment: What your insurer paid to the provider.

Patient responsibility: Copay, coinsurance, or deductible amounts you may owe.

Using your EOB

Compare the EOB to the provider’s bill. If they don’t match, request clarification. EOBs are important evidence when disputing charges.