Patient-side medical billing and paperwork
Make sense of the paperwork that comes with getting care
Plain-language guides to referrals, bills, explanations of benefits and medical records, written for patients. General information only: your plan documents and your insurer have the final word.
What happened? Start here
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A bill arrived and it looks wrong
Set the bill beside your explanation of benefits and compare them line by line before you pay.
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Your claim was denied
Many denials can be appealed. This guide covers the internal appeal and the independent review that can follow it.
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The doctor needs approval first
A checklist for prior authorization: who files, what to confirm and what to keep.
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A word on the paperwork makes no sense
Plain definitions for allowed amount, coinsurance, balance billing and the rest.
Everything in the Paperwork help
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Step-by-step guide
How to read an explanation of benefits (EOB)
What each part of an explanation of benefits means, and how to check a provider's bill against it before you pay.
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Step-by-step guide
Appealing a denied health insurance claim
The general path for appealing a denied claim, from reading the denial letter to an internal appeal and then external review.
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Walk-through checklist
Prior authorization checklist for patients
A before, during and after checklist for getting an insurer's approval before a planned test, procedure or treatment.
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Plain-word glossary
Medical billing terms in plain language
Plain-language definitions of the billing and insurance terms that show up on bills, EOBs and denial letters.
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Editorial promise
Editorial policy: how Care Admin Notes is written
What Care Admin Notes covers, where its facts come from, who has the final word, and how corrections are handled.
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Try-it tool
Out-of-pocket estimator
Estimate what you may owe for one covered service. It is an estimate, and your EOB is what counts.
The topic map
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Appointments and referrals
Getting a referral and keeping it from expiring before the visit.
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Bills and coverage
Reading a medical bill against its explanation of benefits, and disputing a charge.
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Medical records
Requesting your records and moving them between providers.
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Choosing a provider
Checking whether a doctor is in network before you switch.
Questions we hear first
- Is this medical, legal or insurance advice?
- No. Everything here is general information about how medical paperwork usually works. Your plan's documents and your insurer decide what is covered and what you owe. For health questions, ask your doctor or pharmacist.
- Why doesn't my bill match my explanation of benefits?
- There are several common reasons. The bill may have been sent before the insurer finished processing the claim, the provider may be billing a different amount than the plan allowed, or a service may have been billed separately. Compare dates of service and amounts line by line, then call the billing office and the insurer.
- Where do the rules in these guides come from?
- Where a guide describes a federal rule, it links to healthcare.gov or to the Centers for Medicare & Medicaid Services at cms.gov. State rules and the terms of your own plan can differ, so check them too.
- Does this site collect my personal or health information?
- The site has no accounts and no tracking, and the estimator runs in your browser without sending anything. Please keep personal and medical details out of any message you send us.
What each guide promises
Medical paperwork affects your money and your care, so each page says what it can and cannot tell you.
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Who decides
What a plan covers, and what you owe, is settled by its documents and by the insurer. Each guide says when to call them.
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Written for patients
We explain the process from your side of the counter and tell you what to ask for at each step.
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Federal rules, at the source
Where a rule comes from federal law, we point to healthcare.gov or to the Centers for Medicare & Medicaid Services at cms.gov, which publish it.
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Paperwork, not medicine
Questions about your health or treatment go to your doctor or pharmacist. This site covers the paperwork only.