Compare a bill with your explanation of benefits

An explanation of benefits is not a bill: it is your insurer telling you what it paid and what it says you owe. Comparing the two documents shows whether the provider is asking for the amount your insurer says is yours.

Who this applies to

This is for you if

You have both a provider statement and an explanation of benefits for the same care
The amount the provider is asking for looks higher than your EOB suggests
Your EOB shows the plan paid something, but the statement does not reflect it
You want to check before paying, rather than after

This will not help with

— Deciding whether your insurer processed the claim correctly
— Interpreting your policy terms, deductible or coinsurance
— Appealing a denial, which is a separate process
— Situations where you have no insurance involved at all

What to gather first

The provider statement, showing the amount now due
The explanation of benefits for the same dates of service
The claim reference from the EOB and the account number from the statement
The dates of service, which is how the two documents are matched

Steps

Check the dates match. Make sure both documents cover the same care. A statement often covers a different span than a single claim, which explains many apparent differences.
Find your responsibility on the EOB. Look for patient responsibility, or the equivalent wording. That is the figure your insurer says is yours.
Compare it against the amount due. Enter both figures. If the provider is asking for more, the tool says so and by how much.
Check the plan payment appears. If the EOB shows the plan paid but the statement shows no insurance payment, the statement was probably printed before the payment was applied.
Ask for an updated statement. Quote both the claim reference and the account number. Timing differences usually resolve with a corrected statement rather than a dispute.

Common problems

The statement predates the EOB

This is the single most common cause of a difference. The provider billed before the claim finished processing, and an updated statement usually follows on its own.

The two documents describe services differently

Providers and insurers often use different wording for the same service. Matching on the procedure code is more reliable than matching on the description.

One claim covers several statements

If the EOB lists services that are not on this statement, that is usually normal and not a problem in itself.

The provider is out of network

Amounts can differ substantially for out-of-network care. What applies depends on your policy and on where you live, so ask your insurer to explain the calculation.

Questions people ask

Is an EOB a bill?

No. It is a statement from your insurer explaining how a claim was processed: what was billed, what the plan allowed, what it paid, and what it says is your responsibility. It usually says "this is not a bill" somewhere on it.

What if the bill asks for more than my EOB says I owe?

Ask the billing office to review the statement against the EOB, quoting both reference numbers. Timing is the most common cause. If it persists, your insurer can usually explain how your responsibility was calculated.

Does a difference mean someone did something wrong?

No. Most differences are timing or wording. This tool points out a difference so you can ask about it, not so you can accuse anyone of anything.

Do I need to upload the documents?

Not for this tool. You can type in the two figures. Uploading documents is useful when you want the full line-by-line comparison and a saved record.

Which plans include the full comparison?

The basic comparison, which is what this page runs, is on every plan including Free. The advanced line-by-line cross-document analysis is a paid feature. Pricing lists exactly what each plan includes.

This page describes how the tool works and does not make jurisdiction-specific claims, so it cites no external sources. Pages that describe a state or provincial process always do.