An Explanation of Benefits is not a bill — but it can be just as confusing. PlainlyOS reads your EOB and explains what was covered, what you may owe, and whether anything looks worth questioning.
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An EOB is a statement from your insurer summarizing how a medical claim was processed. It shows what the provider billed, what the insurer covered, any adjustments, and what you may owe. It is generally not a bill — the provider sends a separate bill for any amount you owe.
Common reasons include your deductible not yet being met, the service being out-of-network, or the insurer applying a copay or coinsurance. PlainlyOS reads your EOB and explains, in plain terms, which of these appears to apply to your situation.
It means the insurer decided the service was not covered under their criteria. This does not necessarily mean the care was inappropriate. You may have the option to appeal; PlainlyOS flags any appeal deadline it finds on the document.
Start by understanding the stated reason for the denial, which PlainlyOS explains plainly. If an appeal deadline appears on the EOB, it is highlighted. For the appeal itself, consider contacting your insurer or a licensed advisor.
Upload it and PlainlyOS explains what it means, what matters, and what you may need to do — in plain English.
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