KeepMD EOB Decoder

Recomputes one EOB line or claim total from the printed amounts (billed, allowed, plan paid, deductible, copay, coinsurance, non-covered, patient responsibility) and reports the contractual adjustment, the expected patient responsibility and plan payment, and any discrepancy such as a balance bill or a mismatched total. Use it when a user gives EOB or bill amounts and asks whether what they owe is right; it returns an itemized, exact calculation with stated assumptions. Pure arithmetic; takes dollar amounts only, never names or identifiers.

Returns KeepMD's plain-language definition, a worked example and related terms for an insurance or medical-billing term from its glossary (allowed amount, deductible, coinsurance, balance billing, CO/PR group codes, No Surprises Act, observation status and about 110 more). Use it when a user asks what a word, column or abbreviation on an EOB, Medicare Summary Notice or bill means, including common ones such as allowed amount, billed amount, deductible or CO. Takes one term per call.

Returns KeepMD's step-by-step guide, red flags and links to official consumer resources for reading an Explanation of Benefits (overview), resolving a bill that looks wrong (dispute), appealing a denial (appeal), or the handful of terms that drive the arithmetic (glossary). Use it when a user asks how to read an EOB, what to do about a bill that looks wrong, or how to appeal a denial.

Checks codes against the current official releases, which change every year, and reports whether each is valid, billable or terminated today. Returns the official descriptor for ICD-10-CM diagnosis codes, HCPCS Level II service/supply/drug codes and HCPCS modifiers found on an Explanation of Benefits or medical bill, plus the chapter, a plain-language note where KeepMD has one, the data version, and licensing notices for CPT, dental, NDC and X12 remark codes (which are recognized but not described). Use it for any code a user asks about, including common ones such as Z00.00, 99213, J0696 or CO-45. Accepts every code from a statement in one call.

Finds ICD-10-CM diagnosis codes and HCPCS Level II service, supply and drug codes whose official description matches words from a statement (everyday wording such as "flu shot" or "x-ray" is translated to the clinical terms), or whose code starts with the given characters. Use it when the statement prints a description but no code, or the code is partly illegible. CPT (5-digit) physician-service codes such as office visits and lab panels are not searchable because their text is licensed.