EOB Vocabulary

Charge Amount
Amount charged by the provider related to your care. This represents the normal fee that the provider has designated as appropriate for the services provided. Think of this as the retail price or billed amount.

Allowed Amount
This is the amount pre-negotiated by your insurance company and its network of providers for the services you received. This amount also takes into account what is referred to as “usual and customary” (UCR) charges and is impacted by geographic location of provider. Also known as eligible expense, payment or negotiated rate.

Due from Patient / Patient Responsibility
This is the amount the patient is responsible for paying to the provider. This includes the copay amount, amount towards deductible, as well as any non-covered charges associated with your care. Also known as patient responsibility or balance due.

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