What equation determines how patient responsibility is calculated when posting payments from an explanation of benefits (EOB)?

The equation that correctly determines how patient responsibility is calculated from an explanation of benefits (EOB) is derived by considering the relationships between charges, payments made by the insurance, and any adjustments that may need to be applied.

In this context, the patient responsibility is calculated by taking the total charges for services rendered and subtracting both the payments made by the insurance and any adjustments applied. This results in the final amount that the patient is responsible for paying.

Using this understanding, the correct equation is calculated as follows:

1. Start with the total charges incurred by the patient.

2. Subtract any payments that have been made on behalf of the patient by their insurance provider.

3. Additionally, account for any adjustments, which may include discounts, write-offs, or any other modifications to the total bill.

The correct representation is therefore:

Charged - Payment - Adjustment = Patient Responsibility.

This equation clearly shows that the patient's financial obligation arises from the initial charges reduced by the contributions of the insurance and any adjustments applied.