Audit intermediate Works with: Any AI

Itemised Medical Bill and Explanation of Benefits Reconciliation (Billing Only)

Table output Has example

Reconcile an itemised medical bill with the insurer's explanation of benefits for billing questions only, without medical advice.

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[VERIFY] is an editorial flag, not a blank to fill. Wherever the prompt shows [VERIFY], check that item against a reliable source before you use it.

Reconcile my medical bill with my insurer's explanation of benefits. The itemised bill: [ITEMISED_BILL]. The explanation of benefits: [EOB_TEXT]. My policy summary of deductible and co-payments: [POLICY_SUMMARY]. Dates of service: [SERVICE_DATES].

Match each line on the bill to the insurer's statement. Create a table with Date, Service description, Billed, Allowed by insurer, Insurer paid, What the statement says I owe, What the bill asks me to pay, and Difference. Flag lines billed twice, services with the same date and similar codes, charges that the insurer denied or adjusted, and amounts that exceed what the explanation says I owe. Calculate the total I owe from the explanation and compare with the bill, showing the arithmetic. Draft a billing office query listing the lines and asking for correction or an explanation. Add questions about financial assistance or payment plans.

Do not comment on treatment or clinical necessity. Mark rules about balance billing and appeals [VERIFY].

This is not legal advice. Quote no statute from memory. Use [JURISDICTION] and [RELEVANT_LAW_OR_POLICY_IF_KNOWN] as given. Point me to a consumer agency. Promise no result.

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Date | Service | Billed | Insurer allowed | Insurer paid | EOB says I owe | Bill asks
4 Mar | Lab panel | 210.00 | 96.00 | 76.80 | 19.20 | 210.00
4 Mar | Lab panel (repeat) | 210.00 | 0.00 | 0.00 | 0.00 | 210.00
9 Mar | Office visit | 160.00 | 110.00 | 88.00 | 22.00 | 160.00
Total I owe per EOB: 19.20 + 0.00 + 22.00 = 41.20. Total bill asks: 580.00.
Questions for the billing office: why is the lab panel billed twice on 4 March, and why does the balance ignore the insurer's adjustment? Please resubmit to the insurer and send a corrected statement. I will pay 41.20 on receipt.

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