PatientStand example case
The bill says $1,240. Your plan says $720.
A hospital bill and your insurer’s Explanation of Benefits describe the same claim. They should agree on what you owe. When they don’t, the gap is real money, and you need to know why before you pay.
Illustrative example, built on sample bills.
The documents
Two documents, one claim, one visit. The provider’s statement asks you for $1,240. Your plan’s EOB puts your responsibility at $720.
What didn’t add up
The bill and the EOB agree on almost everything: the amount billed, the network discount, the allowed amount. They part company on one line, the insurance payment. The plan’s EOB records that it paid $1,800. The provider’s bill credits only $1,280. That uncredited $520 is the whole difference between the $1,240 you’re being asked for and the $720 your plan says you owe.
What Patient Stand checked
Instead of taking the bill’s figure at face value, we set it against the EOB and worked through it.
- Do the bill and the EOB refer to the same claim, provider and date?
- Do the billed amount, the discount and the allowed amount match across both?
- Was the plan’s full payment credited on the bill?
- Does what the bill says you owe match what the EOB says you owe?
What we prepared
The plan paid $1,800. The bill credited $1,280. So $520 was never posted.
- Your plan’s EOB, plan paid
- $1,800.00
- The provider’s bill credited
- $1,280.00
- Not yet posted on your bill
- $520.00
The bill asks $1,240.00. Your plan puts your share at $720.00.
We prepare a billing inquiry to the provider that points to the EOB, names the uncredited payment, and asks for a corrected statement. You send it.
What you don’t have to do
You don’t have to read an EOB against a bill line by line, work out which figure is right, or know that an uncredited insurance payment is even a thing that happens. We line the two documents up and find where they diverge.
You stop guessing which number to trust.
What happens next
You review the inquiry we’ve prepared. It’s addressed to the provider’s billing office, and we tell you where it goes. You send it. When they reply, send it to us. We’ll help you understand the answer during your 30 days of included support.
Why this matters
Your provider’s bill and your insurer’s EOB should tell the same financial story. When they don’t, you need to know why before treating the larger number as money you owe.
Here, Patient Stand has isolated the entire $520 difference and turned it into a specific question the provider has to answer.
Got a bill that doesn’t match your EOB?
Give us both documents. We’ll work out where they diverge, what it means and what needs to happen next. Then we’ll prepare what you need to act on it.