Glossary · Definition · v2026.3
Explanation of Benefits (EOB)
An Explanation of Benefits is a statement from an insurance company showing how a medical claim was processed, what the insurance company paid, and what portion of the bill the patient is responsible for.
How to read an EOB
An EOB typically shows: the billed amount from the provider, the allowed amount (what insurance considers reasonable), the amount insurance paid, and the patient responsibility (deductible, coinsurance, or copay). Comparing the EOB against the itemized hospital bill can reveal billing errors.
Common issues
Patients sometimes receive an EOB showing a denied claim. This may be due to incorrect coding, missing prior authorization, or disputes about in-network versus out-of-network status. Denied claims can often be appealed.
Related reference
Used in
This content defines terminology for educational orientation. It does not constitute medical advice.
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