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Select a denial code

Click any code on the left to see what it means and how to appeal it.

Understanding Your EOB Fields

Billed Amount (Charged Amount)

The full price your provider charged. This is almost always higher than what insurance actually allows. It's not what you owe.

Allowed Amount (Negotiated Rate)

The amount your insurer and in-network provider agreed to accept as full payment. Cost-sharing is based on this amount, not the billed amount.

Deductible Applied

The portion of the allowed amount applied to your annual deductible. Once your deductible is met, this column should show $0.

Copay

A fixed dollar amount you pay per service (e.g., $30 for a primary care visit). Copays are separate from deductibles and coinsurance.

Coinsurance

Your percentage share of costs after the deductible is met. If you have 20% coinsurance, you pay 20% of the allowed amount and insurance pays 80%.

Plan Paid

What your insurance company actually paid to the provider. If this shows $0 when you expected coverage, review the denial codes on the EOB.

Member Responsibility

The total amount you owe: deductible + copay + coinsurance. This is what you'll see on your provider's bill. Do not pay more than this amount.

Contractual Adjustment (write-off)

The difference between the billed amount and the allowed amount. In-network providers agree to write off this amount — you don't owe it.