Patient responsibility

What does Patient responsibility mean on a medical bill?

Patient responsibility is the line at the bottom of the EOB where your plan adds up what it says is yours: deductible, copay, coinsurance, and anything it did not cover. It is the plan's answer to one claim, and for in-network care the provider's bill should land on the same number. Comparing those two figures takes a minute and catches most of what goes wrong on a medical bill, because the mistakes that cost real money show up as a gap between them.

What does Patient responsibility usually cost?

This number already accounts for the plan's discount, so it is normally far below the charge on the bill. Anything above it on an in-network bill needs an explanation before it needs a payment.

What should I watch out for with Patient responsibility?

• A bill above the patient responsibility line for the same claim — ask which claim the biller used
• Two statements for one visit each showing the full responsibility amount
• Responsibility that includes lines the EOB marked as not covered — ask why the service was excluded