What Is an EOB and How to Read It
Decode billed amount, allowed amount, insurance paid, and patient responsibility without guesswork.
Updated 2026-03-26Billed vs. allowed amount
Billed is what the provider charged. Allowed is what your plan recognizes. Big gaps are normal for in-network contracts but can signal out-of-network exposure.
Insurance paid and adjustments
Insurance paid is the amount your plan covered. Adjustments include contractual write-downs and should reduce your final balance.
Patient responsibility line
This line combines deductible, copay, and coinsurance. Compare it against your policy and prior deductible progress.
Reason codes are the signal
Reason codes explain exactly why money shifted from insurer to patient. Track repeated codes; they often reveal process errors you can appeal.
Ready to apply this to your own bill?
Upload your EOB and get a claim-by-claim review with an appeal prep plan.
Analyze My EOBNeed outside help?
Use official resources and vetted marketplaces to compare options and escalate appeals.
FAQ
Is an EOB a bill?
No. It is an explanation from your insurer. You still need to compare it against the provider bill.
What if my EOB and provider bill do not match?
Call the provider billing office first, then insurer member services with claim IDs and reason codes.