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May 13, 2019

What Is the Difference Between the Explanation of Benefits vs a Medical Bill

What is the Difference Between the Explanation of Benefits (EOB) and a Medical Bill?

The Explanation of Benefits (EOB) is a statement of charges created by your insurance company, usually after you have seen a provider. It includes:

  1. Details concerning the services performed by the healthcare provider
  2. The healthcare provider’s charges
  3. How the charges are processed by your insurance company

Learning how to read your EOB can help you track your expenses and avoid paying too much for services, it is not a bill.
 
A medical bill is a statement created by your healthcare provider of the amount that is owed by the patient. It can take over 30 days for you to receive the bill due to processing time and whether or not the provider had to send an appeal or documentation to the insurance carrier. The medical bill should show:

  1. Payments made at the time of service
  2. How much your insurance company paid
  3. How much you owe

You should compare the EOB to the medical bill to determine if the procedures and charges are correct. Mistakes can happen. If you have questions or need help reading either document, do not be afraid to reach out to your provider or insurance carrier.