Medical Billing

Claim Status

DOS:
Claim number #
Received date#
Status#

Process date#
Paid Amount#
Allowed Amount#
PR#
Discount amount#
EFT/Chek No#
EFT/Chek date#
Bulk/single=
Bulk amount#
Fax#

Denied date#
reason#
Ref#
Rep#

How to calculate different amounts on EOB and ERA

Billed Amount (100) =   Allowed amount (50) + Adjustment amount (50) 

Adjusted amount (50) = Billed amount (100) – Allowed amount (50)

 Allowed Amount (50) =   paid amount (30) + Patient responsibility (20)

Paid Amount (30) =   Allowed amount (50) – Patient responsibility (20)

Patient responsibility (20) = Allowed amount (50) – Paid amount (30)

Rejected amount (20) = Allowed amount (50) – Paid amount (30)