Bill vs. EOB vs. Receipt
Three words that solve most “what do I owe?” questions
If you have ever opened an envelope (or a portal message)and thought, “Wait… didn’t I already pay this?” you are not alone.
Most medical claim confusion comes down to mixing up three documents:
- Bill
- EOB (Explanation of Benefits)
- Receipt
They are related, but they are not interchangeable. Here is what each one means, what to look for, and how to use them together.
1) Bill
A bill comes from your doctor, clinic, hospital, lab,or other healthcare provider. It reflects what they charge for the visit orservice.
What a bill usually includes
- Provider name and contact info
- Date(s) of service
- List of services and charges
- Amount due (sometimes after insurance, sometimes before)
Common bill scenarios
- Provider bills insurance first, then bills you for the remaining balance
- You pay upfront (often for out-of-network care) and later submit for reimbursement
- You receive a bill before insurance finishes processing, especially if the claim is still pending
Good to know: A bill is not always the final word. It is often the starting point.
2) EOB (Explanation of Benefits)
An EOB is sent by your insurance carrier after a claim is processed. It is a summary of how the plan handled the claim.
An EOB is not a bill.
What an EOB tells you
- What the provider billed
- Any plan discounts or network adjustments
- What your plan paid
- What you may owe (copay, deductible, coinsurance)
- The reason a claim was denied or adjusted (if applicable)
Why the EOB matters
The EOB is where you can confirm whether:
- the claim was processed in-network
- the deductible was applied
- the payment amount looks right
- there are any denial codes that need follow-up
Tip: If you only look at the provider bill without reviewing the EOB, it is easy to assume something is wrong when it is simply still in process.
3) Receipt
A receipt is proof that you paid.
It comes from the provider, the pharmacy, or the payment method you used (online payment confirmation, credit card receipt, etc.).
What a receipt usually includes
- Date paid
- Amount paid
- Who you paid
- Sometimes the service or invoice reference
When receipts matter most
Receipts are commonly needed for:
- HSA or FSA documentation
- Out-of-network reimbursement submissions
- Wellness benefits or incentives that require proof of payment (plan-dependent)
Note: A receipt proves payment. It does not explain how insurance processed the claim. That is what the EOB is for.
Use Them Together: The Simple Order
When something looks confusing, line them up like this:
Bill → EOB → Receipt
A quick example
- You receive a bill for $600
- Your insurance sends an EOB showing an in-network discount and that you owe $120
- You pay the $120 and keep the receipt as proof
If those three documents do not match up, that is your signal to ask questions.
Quick Troubleshooting Tips
If something feels off, start here:
- Bill shows a balance, but you already paid: Check for a matching receipt and confirm the payment posted to the correct account.
- Bill amount is higher than expected: Review the EOB to see if the claim is still pending, denied, or applied to deductible.
- EOB says you owe $0, but you got a bill: Call the provider’s billing office and ask them to confirm they received the insurance payment and adjustments.
- EOB shows out-of-network when you expected in-network: Confirm the provider’s network status at the time of service and double-check that the claim was filed with the correct provider information.
Still Need Help?
If you are not sure what you are looking at, you do not have to figure it out alone.
Maddock & Associates can help you understand what the documents mean and what your next step should be. Reach out to our team and we will point you in the right direction.
