Bills and insurance
Medical bill and insurance statement explainer
Bills and insurance statements mix procedure codes, adjustments and several different totals. Add yours below and each line is explained: what the service was, what was charged, what was taken off, what the insurer paid and what the statement says is left.
Explain your medical bill and insurance statement
- 1. Add itDrop a PDF, take a photo or paste the text.
- 2. Check itPersonal details are removed on your device. You approve what is sent.
- 3. Read itSummary, table of results, terms and questions to ask.
The explainer opens on its own page with no adverts and no outside scripts. Your file is read on your device and is never uploaded.
What you get
- Each charge on its own row with the amounts as printed.
- Plain-language meanings for terms such as deductible, coinsurance, copay and adjustment.
- The totals explained, including the amount the document says is due.
- Questions you could ask the billing office or your insurer.
Documents people bring here
- Hospital and clinic patient statements
- Itemised bills listing each service
- Explanation of Benefits (EOB) statements from an insurer
- Laboratory and imaging invoices
- Pre-authorisation and claim decision letters
What this tool cannot tell you
MedicDecode explains what the document says. It cannot see your insurance policy, so it cannot tell you whether a charge is correct or whether a claim should have been paid. It does not give legal or financial advice. If a line looks wrong, ask the billing office for an itemised bill and contact your insurer.
Common questions
Is an Explanation of Benefits a bill?
Usually not. An EOB is your insurer's record of how a claim was processed. The bill comes from the hospital or clinic. Comparing the two is a good way to check that the amounts agree.
Will it tell me if I was overcharged?
No. It can show you what each line means so you know what to ask, but only the provider and your insurer can confirm whether a charge is right.
Are account and member numbers sent anywhere?
They are removed in your browser before anything is sent, along with names, addresses and phone numbers. You see the redacted text and approve it first.
Words you may see on this report
Tap a word for its plain-English meaning, an example line and what it does not mean.
- Copay
A copay is a fixed amount you pay for a covered health service or prescription, such as a set fee for each doctor visit.
- Coinsurance
Coinsurance is the percentage of a covered health care cost you pay after meeting your deductible, such as 20 percent of the allowed amount.
- CPT Code
A CPT code is a five-character code that describes a medical service or procedure, used on bills and insurance claims in the United States.
- Deductible
A deductible is the amount you pay for covered health care each year before your insurance starts paying its share.
- Explanation of Benefits (EOB)
An explanation of benefits (EOB) is a statement from your insurer showing what was billed, what the plan paid and what you may owe for a claim.
- ICD-10 Code
An ICD-10 code is a letter-and-number code that describes a diagnosis, symptom or reason for care on medical records and bills.
- In-Network
In-network means a doctor, hospital or pharmacy has a contract with your insurance plan to provide care at agreed prices.
- Out-of-Pocket Maximum
The out-of-pocket maximum is the most you pay for covered, in-network care in a plan year; after that, the plan pays 100 percent of covered services.
- Prior Authorization
Prior authorization is approval your insurer must give before certain treatments, tests or medicines are covered.