An EOB shows billed $80, allowed $60, and a $20 copayment. Which amount should be posted as the insurance check amount?

An EOB shows billed $80, allowed $60, and a $20 copayment. Which amount should be posted as the insurance check amount?

• A. $80
• B. $60
• C. $40
• D. $20

Answer: (C)

When posting an EOB, the insurance payment is based on what the payer considers the allowed amount, minus what the patient is responsible for. Here, the allowed amount is 60 and the patient has a copay of 20. So the insurer’s portion is 60 minus 20, which equals 40. That 40 is the amount that should be posted as the insurance check. The difference between billed and allowed (80 minus 60 = 20) is typically an adjustment written off, not the amount paid by insurance. The copay of 20 is patient responsibility and is handled separately, often collected at the point of service. The other options would not reflect the actual insurer payment: the full billed amount isn’t paid by insurance, and the full allowed amount isn’t paid unless there’s no patient responsibility.

When posting an EOB, the insurance payment is based on what the payer considers the allowed amount, minus what the patient is responsible for. Here, the allowed amount is 60 and the patient has a copay of 20. So the insurer’s portion is 60 minus 20, which equals 40. That 40 is the amount that should be posted as the insurance check.

The difference between billed and allowed (80 minus 60 = 20) is typically an adjustment written off, not the amount paid by insurance. The copay of 20 is patient responsibility and is handled separately, often collected at the point of service. The other options would not reflect the actual insurer payment: the full billed amount isn’t paid by insurance, and the full allowed amount isn’t paid unless there’s no patient responsibility.