Check EOB arithmetic
check_eob_mathRecomputes 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.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| copay | No | Copay amount. | |
| billed | No | Provider's billed charge for the line or claim. | |
| allowed | No | Plan's allowed, approved or eligible amount. | |
| plan_paid | No | Amount the plan paid. | |
| deductible | No | Amount applied to the deductible. | |
| in_network | No | false for an out-of-network claim. Defaults to true. | |
| non_covered | No | Non-covered amount the statement assigns to the patient (PR group), if any. | |
| coinsurance_rate | No | Coinsurance percentage, for example 20 or 0.2, if the dollar amount is not printed. | |
| coinsurance_amount | No | Coinsurance in dollars, if printed. | |
| patient_responsibility | No | Total the statement says the patient owes. |