The EOB is your insurer's record of what it paid and what it says you owe. The bill is what the provider asks for. When they differ, this letter asks the billing office to correct the bill.
[Your name]
[Your mailing address]
[Today's date]
[Billing office name]
[Billing office address]
Re: Bill does not match my explanation of benefits. Patient: [Patient name]. Account: [Account number]. Date of service: [Date of service].
To the billing office:
Your bill asks me to pay [amount billed to you] for the date of service above. My insurer's explanation of benefits for the same date shows [amount on the EOB] as my share.
My insurance is [insurer and member ID]. Please check that this claim was billed to my insurer correctly, apply the insurer's payment and adjustments, and send me a corrected bill. If you believe the amount you billed is correct, please explain the difference in writing.
Please hold this account, and do not send it to a collection agency, while this is resolved.
Thank you,
[Your name]
The numbers, worked
An EOB for one visit: billed $1,240; allowed amount $620; plan paid $496; your share $124. If the bill asks for $744, that is $1,240 minus the plan's $496, with the $620 adjustment never taken off. The letter asks the office to apply it.
What to compare
- The date of service and the provider name.
- The billed amount on both.
- The adjustment or discount on the EOB, and whether the bill shows it.
- The plan's payment, and whether the bill shows it as received.
- Your share on the EOB against the balance on the bill.
For the full line-by-line check, use the error checklist.
Questions people ask next
What is an EOB?
An explanation of benefits is a statement from your insurer about a claim: what was billed, what the plan allowed and paid, and what it says you owe. It is not a bill.
The bill came before the EOB. Should I pay it?
You can ask the billing office to hold the account until your insurer has processed the claim, and compare the two when the EOB arrives.
What if the hospital billed the wrong insurance?
Call the billing office with your current insurance card, then send this letter with your insurer's name and member ID so it is on record.
What if my insurer denied the claim?
That is a question for your insurer. Read the reasons on the EOB, and ask your insurer how to ask it to reconsider.
For the phone calls
The Medical Bill Fight Kit
A 9-page PDF you print: the order of steps, word-for-word call scripts for the billing office, your insurer, financial assistance and a collection agency, five letters with blanks (the three free ones here, plus a financial assistance request and a payment agreement confirmation) and a call and mail log.
$9 Buy the kit
If the file doesn't work or isn't what this page describes, write to us within 14 days for a full refund.
Bill Pushback