EOB responsibility mismatch
The EOB said $118. The provider billed $412.
After insurance processed the claim, the EOB clearly listed the patient responsibility. The provider statement that arrived later asked for hundreds more.
EOB patient share$118
Provider billed$412
Difference$294
What happened
1
The EOB set the patient responsibility
The insurer processed the claim and printed a patient responsibility of $118 for the visit.
2
The provider statement asked for more
The later bill showed the same provider and service date, but requested $412 from the patient.
3
The mismatch became a concrete dispute
Insured Guard compared the invoice to the EOB and flagged the $294 difference as a balance above the processed patient responsibility.
Once the EOB sets the patient responsibility, a larger provider bill needs an explanation.
How do we know
It compares the bill against the adjudicated claim.
The provider statement is matched to the EOB by date, provider, member, and claim details. If the bill asks for more than the EOB patient responsibility, the difference is surfaced as a billing mismatch.