Educational only, not legal or financial advice; not affiliated with any hospital or insurer.

How to read an EOB: a short checklist

An Explanation of Benefits (EOB) comes from your insurer. It isn't a bill. It shows what the provider charged, what your plan allowed and paid, and what the plan says you owe. Check it against the itemized bill from the provider before you pay.

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1. Find these fields on the EOB

EOB field (names vary)	What it means
Claim number, provider, date of service	Which visit this is. Make sure it's yours and the dates match the bill.
Amount billed / charged	What the provider sent the insurer.
Allowed amount / plan discount	The price your plan agreed to. The difference is often a discount you don't owe on in-network care.
Plan paid	What the insurer paid the provider.
Deductible, copay, coinsurance	Your share under your plan.
Not covered / denied, with remark or reason codes	Lines the plan didn't pay, and why. The EOB explains the codes, usually on the back or at the end.
Patient responsibility / what you owe	The plan's total for your share. Compare this with the provider's balance.

2. Compare it with the itemized bill

The patient name, insurance ID and dates of service match.
The bill's balance matches the EOB's "patient responsibility". If the bill asks for more, ask the billing office why.
The insurer's payment shows on the bill, and the plan discount or adjustment has been applied.
No line appears twice for the same service on the same date (unless you really had it twice).
Quantities look right (for example days, units or doses).
You recognize every service, supply and medication. Note anything you don't think you received.
For any denied line, you've read the reason code and noted the appeal deadline on the EOB.
If no EOB has arrived, ask the provider whether they billed your insurer, and ask the insurer whether a claim was received.

3. Ask in writing, and keep notes

Write down the date, the person's name and what they said for every call.
Ask the billing office to explain any line you don't understand, and to correct anything that's wrong.
Ask the insurer about a denial or a line that doesn't match. Your EOB explains how to appeal.
Ask about financial assistance. Tax-exempt (501(c)(3)) hospitals must have a written financial assistance policy under federal tax rules (IRS: section 501(r)(4)).

Write my itemized bill request

This checklist is general information, not legal or financial advice. Plans and EOB layouts differ; your insurer's own explanation on the EOB comes first.