You went to the doctor, and now you've received a multi-page document from your insurance company full of numbers and medical codes. Don't throw it away - and don't pay it yet. It's not a bill.
What Is an EOB?
An Explanation of Benefits (EOB) is a summary of how your insurance company processed a medical claim. It shows what the provider charged, what your insurance paid, and what you may owe.
Key Sections to Review
- Date of service: Does this match when you were seen?
- Provider: Is this the right doctor/facility?
- Amount billed: What the provider originally charged
- Allowed amount: The negotiated rate between your insurer and the provider
- Insurance paid: What your insurer covered
- Your responsibility: What you owe (deductible, copay, coinsurance)
Common Errors to Watch For
- Services you didn't receive
- Duplicate charges
- Wrong date or provider
- Out-of-network charges for in-network providers
- Preventive care coded incorrectly (should be covered at 100%)
What to Do If You Find an Error
Contact your insurance company first. If the error is on the provider's side, call their billing department. Keep records of all calls and correspondence. Billing errors are more common than you'd think - and they're worth disputing.