Understanding my bill
Understanding Your Medical Bill or Explanation of Benefits
By Cura Editorial Team ·
Quick answer
An Explanation of Benefits is not a bill. It is a summary from your insurance company showing what was charged, what they covered, and what you may owe. If something looks wrong or confusing, tell Cura what you are looking at and we will explain it in plain language and tell you what to ask.
What is an Explanation of Benefits?
An Explanation of Benefits, or EOB, arrives after any medical service. It comes from your insurance company, not your doctor. It is not a bill. It is a summary of what happened with your claim. An EOB shows four things: what your provider charged, what your insurance plan paid, what was adjusted or written off, and what you may owe — called your patient responsibility. You will receive a separate bill from your provider. The EOB helps you check whether that bill is correct before you pay it.
What does patient responsibility mean?
Patient responsibility is the amount your insurance company says you owe after processing the claim. It typically includes your deductible, your copay, or your coinsurance. If your EOB shows a patient responsibility amount, your provider will send a bill for that amount. Compare the two — they should match.
What does it mean when insurance denies a claim?
A denial means your insurance company did not pay for a service. Common reasons include missing prior authorization, an out-of-network provider, a billing code error, or a service the plan considers not medically necessary. A denial is not the final word. You have the right to appeal. Your EOB will include the reason code and instructions for how to do so.
What to do if your bill looks wrong
Before paying any medical bill, compare it to your EOB line by line. If something does not match, call your provider's billing department first, not your insurance company. Ask for an itemized bill that lists every individual service and charge. Keep a record of every call: the date, the name of the person you spoke with, and what they said.
How to appeal a denied claim
You have the right to appeal any insurance denial. Find the denial reason code on your EOB. Ask your doctor for a letter of medical necessity if the denial was for lack of medical necessity. Submit your appeal before the deadline — usually 60 to 180 days from the denial date. If your internal appeal is denied, you may be eligible for an external independent review, which is a legal right under federal law.
Tell Cura what you are looking at
Paste any line from your medical bill or EOB, or attach a photo or PDF of the bill itself. Cura will explain it in plain language and tell you what to ask your insurance company or billing department.
Anonymous. Nothing you type or upload is saved — files are only read to answer you.
Common questions
What is an Explanation of Benefits?
An Explanation of Benefits (EOB) is a document your health insurance company sends after you receive medical care. It is not a bill. It shows what your provider charged, what insurance paid, and what you may owe. Your actual bill will come from your provider separately.
Is an EOB a bill?
No. An EOB is not a bill. It is a summary from your insurance company showing how your claim was processed. Your provider will send a separate bill for any amount you owe. Always compare the two to make sure they match.
What does patient responsibility mean on an EOB?
Patient responsibility is the amount your insurance company says you owe after processing the claim. It typically includes your deductible, copay, or coinsurance. This is the amount your provider's bill should match.
What does it mean when insurance denies a claim?
A denial means your insurance did not pay for a service. Common reasons include missing prior authorization, an out-of-network provider, or a billing code error. A denial is not always final — you have the right to appeal.
What should I do if my medical bill looks wrong?
Call your provider's billing department and request an itemized bill. Compare it line by line to your EOB. If they do not match, ask the billing team to explain the discrepancy.
How do I appeal an insurance denial?
Find the denial reason on your EOB, write a brief appeal letter, ask your doctor for a letter of medical necessity if needed, and submit the appeal before the deadline — usually 60 to 180 days from the denial date.