The short version
The bill from the provider and the Explanation of Benefits from your insurer are two views of the same charges, and they disagree more often than anyone admits. Before you pay anything, match them line by line. The number that matters is the patient responsibility on the EOB. If the bill asks for more than that, the bill is wrong until proven otherwise.
Match your bill against your EOB, freeType the lines in. The matcher flags duplicates and does the totals math on your device.
The four numbers on every EOB
| EOB column | What it means |
|---|---|
| Billed amount | What the provider charged. A starting ask, not what anyone pays. |
| Allowed amount | The price your plan and the provider agreed on. Everything is based on this number. |
| Plan paid | What the insurer actually paid the provider. |
| You owe / patient responsibility | The only number the provider should be billing you. |
What the matching usually finds
- Duplicate lines: the same code, same date, charged twice.
- Bill higher than the EOB: the provider billed your deductible or coinsurance at the full charged price instead of the allowed price.
- Charges the EOB does not show at all: a bill for a claim the insurer never received, or a second bill for a claim that was already paid.
- Simple addition errors in the bill total.
What to do with a gap
- Call the provider billing office with both documents open and name the exact line that disagrees.
- Ask them to rebill or correct the line and to hold the account while it is fixed.
- Get the name of the person you spoke with and the date. Write it on the bill.
- If the provider will not fix a clear error, the call script on DueEasy walks the conversation, including asking for an itemized bill with codes.