Is this medical bill right?

Answer a few questions from your bill and your insurer’s statement. Get a plain-English answer, what to do next, and a letter you can send.

What’s an EOB?

An Explanation of Benefits is the statement your insurer sends after it processes a claim. It is not a bill. It shows what the provider charged, the discount your plan negotiated, what insurance paid, and what you owe. Your provider’s bill should not ask for more than that last number. You can usually find EOBs in your insurer’s app or website under “Claims”.

Everything runs in your browser. We don’t ask for your name, and your numbers are not uploaded or saved.

Does my bill match my EOB?

Do you have the EOB for this visit? Yes Not yet

From the EOB

Look for the totals row for this visit. Names vary by insurer.

Amount billed “Billed”, “Charges”, “Amount claimed” Plan discount “Discount”, “Adjustment”, “Not allowed”, “Savings” Insurance paid “Plan paid”, “Paid to provider” Your responsibility “You owe”, “Patient responsibility”, “What you may owe” EOB date optional

From the provider’s bill

Amount the bill asks for “Amount due”, “Balance”, “Please pay” Statement date optional Already paid for this visit copay at check-in, earlier payments

The bill lists more than one date of service The bill includes a “previous balance”

Was the provider in your insurance network? In network Out of network Not sure It was an emergency, or I didn’t choose this provider (e.g. anesthesiologist, radiologist, ER doctor)

Why was my claim denied?

Was I charged twice?

You need an itemized bill — a list of every charge with a code and amount. If you only have a summary, ask the billing office for one; they must provide it.