How to read your EOB (Explanation of Benefits)

After a medical visit, your insurance company sends an Explanation of Benefits, or EOB. It's one of the most useful documents you'll get — and one of the most misread. The first thing to know: an EOB is not a bill. It usually says exactly that right at the top.

An EOB shows how your insurer processed a claim. The key figures are the amount the provider billed, the 'allowed amount' your insurer actually recognizes, the amount the plan paid, any discount or adjustment, and finally your patient responsibility — the portion you owe through your deductible, copay, or coinsurance.

Here's the move most people miss: you should generally owe only the patient-responsibility figure on the EOB, not the higher amount the provider billed. When the separate bill from the hospital arrives, compare the two. If the hospital is billing you more than the EOB's patient-responsibility amount, that's a red flag worth questioning.

Scan for denied lines, too. If a service was denied, the EOB lists a reason or remark code. Denials are often reversible — a wrong code, a missing referral, or a coding mistake — and you have the right to appeal through your insurer.

Keep your EOBs and match each one to the provider's bill before paying anything. When the numbers don't line up, the discrepancy is usually in the bill, not the EOB.

ClarifyBill focuses on the itemized hospital bill — reading each code, checking for duplicates and quantity errors, and comparing charges to the Medicare benchmark — which pairs naturally with the cross-check your EOB gives you.