Medical bills come with their own vocabulary. Here are the terms you will see most often.
The terms
- Statement: a bill from your provider
- Explanation of Benefits (EOB): a document from your insurer explaining a claim. It is not a bill.
- Copay: a fixed amount you pay for a covered service
- Deductible: what you pay before your plan starts to pay its share
- Coinsurance: the percentage you share after the deductible
- Allowed amount: the amount your insurer agrees to cover for a service
- Adjustment: a reduction from the billed charge
- Patient responsibility: the amount you owe
- Itemized bill: a detailed list of services and charges
- In-network and out-of-network: whether a provider has a contract with your insurer
Using the terms
When you call a billing office, these terms help you ask clear questions. See understanding patient billing statements and how to check a bill before paying.