Written October 16, 2026 · Updated October 17, 2026 · General information for US households
What the letter means
An explanation of benefits, or EOB, comes from your health plan after it processes a claim. It lists the care reported, the provider’s charges, the plan’s payment, and your share. A medical bill comes separately from the provider or facility and requests payment.
Keep both documents. They describe the same care from different sides. An EOB can help you check a bill, but it may not show payments you already made. Keep your receipts too.
Check the care before the money
Check the patient’s name, provider, service date, and description against the care you received. A single visit may generate separate claims from different providers. Match each bill to the right EOB rather than comparing unrelated totals.
Find the claim number and read the notes or remark codes. Those explanations can tell you why the plan paid a particular amount or did not cover a service. If the care looks unfamiliar, ask the provider to check its records.
Which amount matters?
- Provider charges: what the provider billed before insurance adjustments.
- Allowed charges: the amount the plan recognizes for the service.
- Plan payment: what your insurance paid.
- Your share: often labelled “What You Owe,” “Patient Balance,” or “Patient Responsibility.”
Do not treat the provider’s original charge as the amount you must pay. Compare your share with the matching bill and check whether your earlier payments are credited. Ask about any difference before assuming either document is correct.
Is there a deadline?
There is no single deadline that applies to every EOB. Read your notice for appeal instructions if a claim was denied or coverage is disputed. A payment due date on a provider’s bill is separate from an insurance appeal deadline.
If a date or instruction is unclear, contact the health plan or provider listed on your documents. Ask which deadline applies to your next step and request written confirmation. Do not ignore a deadline while waiting for a corrected bill.
What to do next
For coverage questions, contact your health plan using the number on your EOB or insurance card. For errors on your bill or EOB, contact the provider’s or facility’s billing office. Ask that office about missing payments, unfamiliar services, or a bill higher than the EOB’s patient balance. Have the claim number, service date, EOB, bill, and receipts ready.
Ask them to explain the difference and whether a corrected document will follow. Record the date, who you spoke with, and the answer. Keep any written response with the original letter so the next conversation starts with the facts.
Sources and limits
The Centers for Medicare & Medicaid Services explains how to read an EOB and how to read a medical bill. Your own plan documents and notice control the details of your claim.
Buoyed Delta explains and drafts; it does not give legal advice.
This guide does not provide medical advice or determine what you owe.
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