📄 EOB Upload & Auto-Fill
Drop your Explanation of Benefits — AI fills the entire form automatically
📄
Drop EOB Here or Click
PDF, PNG, JPG • Medicare, UHC, Aetna, BCBS, Medicaid
✅ EOB Parsed Successfully!
👤 Patient Information
Patient Name
Medicare ID (MBI)
Date of Birth
🏥 Claim Information
Claim Number (ICN)
Date of Service
💰 Financial Summary
Billed Amount
Allowed Amount
Sequestration (Code 253)
Patient Responsibility
⚠️ Denial Codes
CARC Codes
RARC Codes
✅ Submit EOB Intake