Medical Bill Too High?

Why Your Medical Bill May Not Match Your EOB

Your medical bill and Explanation of Benefits (EOB) should align, but often they don't. Here are the most common reasons:

• Duplicate Charges: Your provider may bill you twice for the same service due to billing system errors or manual data entry mistakes.
• Coding Errors: Incorrect procedure or diagnosis codes can result in higher charges than what your insurance approved or what you owe.
• Balance Billing: Out-of-network providers or specialists may bill you beyond what your insurance considers reasonable, violating balance billing protections in some cases.
• Out-of-Network Issues: If your visit was out-of-network, your responsibility may be much higher than in-network rates shown on your EOB.

If you find discrepancies, it's important to dispute them early. The sooner you catch a billing error, the better. Learn more about the process and your legal rights in our guide on what happens if you don't pay a medical bill.

How to Compare a Medical Bill to an EOB

Start by locating the billed amount on your provider statement. Then review your Explanation of Benefits (EOB) from your insurance company. Compare the allowed amount and the patient responsibility listed on your EOB to what the provider is requesting. If your provider is charging more than your EOB says you owe, it may indicate duplicate billing, coding issues, or possible balance billing. Reviewing both documents side by side helps you catch mistakes before paying.

Learn More: Medical Bills, EOBs, and Your Rights

Understanding the relationship between your medical bill and EOB is the first step to protecting yourself from billing errors. For deeper insights, check out our comprehensive guides: learn about the EOB vs medical bill guide to understand exactly how these documents differ, and our breakdown of what happens if you don't pay a medical bill to learn your rights and obligations.

Frequently Asked Questions