Electronic medical billing: one claim reconciled to its EOB
- Payer payment to expect
- $57.60
- Contractual adjustment to write off
- $68
- Coinsurance the patient owes
- $14.40
- Patient responsibility, deductible plus coinsurance plus copay
- $54.40
Every figure on a worksheet comes from the inputs you enter and the method stated beside it: your minutes, your charges, your EOB amounts and your month's counts. Where a guide names a published rule, the document is cited with a path to the clause, and the figure is licensed in this repository's claims ledger before it appears on a page.
The figures start from a worked example ($57.60), one visit or one claim from a typical small practice. Change any input and the answer recomputes as you type.
Download the Electronic medical billing: one claim reconciled to its EOB worked example (CSV)
Electronic medical billing ends at the remittance: the EOB or the ERA that says what the payer allowed, what it paid, what it applied to the deductible and what the patient owes. This worksheet reconciles one claim line against those figures. It takes the charge, the allowed amount, the deductible applied on this claim, the coinsurance percent and any copay the payer applied, and returns the contractual adjustment to write off, the coinsurance the patient owes, the total patient responsibility, the payer payment to expect, a check line that adds payment, patient share and adjustment back to the charge, and the allowed amount as a share of the charge. Every input is read from your own EOB; the sheet knows no fee schedule.
Where the constants in this tool come from
Electronic medical billing: one claim reconciled to its EOB: what billers ask
Why does the check line matter?
Because a posting is right only if the payer payment, the patient responsibility and the contractual adjustment add back to the charge. If the check line does not equal the charge, one of the EOB amounts was entered wrong, and the sheet shows it before the posting is made.
What is the difference between the EOB and the ERA?
The EOB is the paper or PDF explanation the payer sends; the ERA is the same information in the HIPAA 835 electronic remittance transaction, which billing software can post automatically. The figures reconcile the same way, and this worksheet takes them from either.
What if the allowed amount is less than the deductible applied?
It cannot be: the deductible applied is part of the allowed amount, never more than it. If the EOB shows otherwise, the claim was processed against more than one line or the deductible crossed into a second claim, and the posting should be made line by line.
Eobify Pro
Keeping the claims register instead of the spreadsheet
Upgrading turns a worked claim into a register. The EOB you reconciled on the worksheet is posted against the claim it paid; the denial is recorded with its code and the appeal with its date; the patient balance carries forward to the next statement; and the month's denial rate, clean-claim rate and days in A/R are a report rather than a spreadsheet nobody trusts.
- Download the superbill or the statement as a file
- Your superbills and statements without our name on them
- Save a claim and reopen it when the EOB arrives
- Your practice name and logo on every printed superbill and statement
- Take every claim, posting and statement out at once
- Send a patient their statement from inside the register
- Not sold on this hub: a practice collects its copays at the desk, not through us
- Not sold on this hub: the month's figures export to your accountant instead
$49per month, whole team
Start Eobify Pro PricingEobify Pro is $49 per month for your whole practice, billed monthly, and renews each month at that price until you cancel. The price and the renewal terms are shown again before checkout.