An EOB is not a bill. Here’s how to read it.

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1. 01

   Name the document

   An Explanation of Benefits, or EOB, is a statement from a health plan showing the care involved and how costs were handled. CMS states the key boundary plainly: an EOB is not a bill.

2. 02

   Orient yourself

   Start with the patient, provider, service, and date. Then find the amount billed, the plan’s allowed amount or discount, what the plan paid, and the amount the statement says you may owe.

3. 03

   Compare before paying

   Payment normally goes to a provider bill, not to the EOB itself. When that bill arrives, compare its service details and amount with the EOB rather than treating either document in isolation.

4. 04

   Route a mismatch

   If the documents do not line up, use the member-services number on the plan document and the billing contact on the provider bill. Ask each organization to explain the specific service and amount in question.