Explanation of benefits.
In plain English
An explanation of benefits, or EOB, is the summary your health plan sends after a doctor or hospital files a claim. It lists the charged amount, the plan's negotiated rate, how much the plan paid, and the portion left for you. An EOB is not a bill, even though it shows a dollar figure, because the actual bill comes from the provider. Reading it carefully is how you catch errors, denied charges, or amounts you were not expecting to owe.
01Why it matters
Comparing your EOB to the bill the provider sends is one of the easiest ways to catch billing mistakes before you pay for them, and those mistakes are common.
02The math, step by step
After a doctor visit, you get an EOB showing a charged amount, the discounted in-network rate, the part the plan paid, and your share. A week later the provider sends a bill. You compare the two: if the bill asks for more than the EOB says you owe, that is your signal to call before paying.
03What this is NOT
An EOB is not a bill. It is a summary of how a claim was processed and usually says "this is not a bill" on it. The actual request for payment comes separately from the provider.
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