Claims and billing
Your explanation of benefits, in plain language.
An explanation of benefits (EOB) shows how your health plan processed a claim, including charges, plan payments, and your share. It is not a bill. Connect a supported plan through Flexpa and ask your AI assistant to explain the EOB data your plan makes available.
Updated 2026-11-11
How it works
- Choose a sourcecheck support
- Authorize accessthrough Flexpa
- Available recordsfor your assistant
- Explaincheck the EOB
What's on an EOB
- Who and when
- The provider, the date of service, and the services or items on the claim.
- How it was paid
- What the provider billed, what your plan paid, and how the claim was adjudicated.
- Your share
- Your cost-sharing on the claim, such as deductible, copay, or coinsurance.
Why read it with AI
Ask your assistant to explain unfamiliar terms and compare an EOB with a bill you provide. Check its explanation against the original records, especially before paying or disputing a charge.
Flexpa provides claims as FHIR ExplanationOfBenefit resources. Available fields vary by payer, so ask the assistant to identify missing information rather than infer an amount.
Before using a yearly total, ask your assistant whether the returned claims cover the whole period or whether the result was limited or incomplete.
What you can ask
- “Explain my most recent EOB in plain language”
- “What's the difference between what was billed and what I owe?”
- “Total the patient responsibility shown on my available EOBs this year”
- “Which EOBs are from my specialist?”
Questions
What is an explanation of benefits?
An explanation of benefits (EOB) is a health plan statement showing how it processed a claim, including charges, plan payments, and patient responsibility. An EOB is not a bill.
Can an AI assistant read my EOBs?
With your authorization, Flexpa can share available EOB data from a supported health plan with a compatible AI assistant. Ask the assistant to explain the amounts and identify any missing fields.
Is an EOB the same as a bill?
No. An explanation of benefits describes how the health plan processed a claim. Compare it with the provider bill and your payment records when checking a balance.
How far back can I see EOBs?
The CMS Patient Access API rule requires affected payers to share data they maintain for current enrollees with service dates on or after January 1, 2016. The EOBs available through your connection depend on the records your plan maintains and shares.
More
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