PayMyDoctor Statement

The Five Sections of a Medical Billing Statement

All PayMyDoctor billing statements are organised in the same way, no matter which provider sent them. Here is what you will find in each section:

Section 1: Provider Information (Top of Statement)

This section lists your healthcare provider’s details:

• Provider or practice name.
• Address and phone number.
• Practice ID, sometimes called Client ID or Provider ID.
• PayMyDoctor.com payment link (may include your Practice ID).

What you’ll need from this section: Your Practice ID for PayMyDoctor.

Section 2: Patient Information

This section lists your information as the patient:

• Your name.
• Your address.
• Your Account Number, sometimes called your Guarantor Number, is your unique billing ID.
• Patient date of birth (if included).
• Insurance policy information.

What you’ll need from this section: Your Account Number for PayMyDoctor.

Section 3: Statement Summary

The key financial overview:

• Statement Date: The day this bill was created.
• Due Date: The day your provider expects payment.
• Previous Balance: Any unpaid amount from earlier statements.
• Insurance Payments: The amount your insurance has paid.
• Adjustments: Write-offs and discounts based on agreements.
• Payments Received: Any payments you have already made.
• Amount Due: The total amount you currently owe.

Section 4: Itemised Charges

Line-by-line breakdown of services:

• Date of Service: The day you received care.
• Service Description: what was done, such as “Office Visit” or “Lab Panel”.
• CPT Code: The code for the medical procedure.
• Billed Amount: The amount your provider originally charged.
• Insurance Adjustment: The discount based on your insurance’s negotiated rate.
• Insurance Paid: The amount your insurer paid.
• Your Responsibility: The amount you owe after insurance.

Section 5: Payment Instructions

Ways you can pay your bill:

• Visit PayMyDoctor.com to pay online.
• Mail your check to the payment address listed below.
• Call the phone number below to pay by phone.
• You may also find a tear-off payment coupon included with your bill.

Common Terms on Medical Billing Statements | Explained

Term	What It Means
Guarantor	The person responsible for paying the bill (usually you)
Guarantor Number	Same as Account Number — your billing ID
EOB	Explanation of Benefits: this is a separate document from your insurance policy
Contractual Adjustment	Discount applied per insurance network agreement
Write-off	Amount the provider agreed not to collect
Deductible	Amount you pay before insurance kicks in
Copay	Fixed amount you pay per visit
Coinsurance	Your percentage share after deductible (e.g., 20%)
Out-of-pocket maximum	The maximum amount you will pay in a year. After you reach this amount, your insurance will cover 100% of your costs.
Balance forward	Amount not paid from your last statement
Date of service	When you actually received the medical care
CPT code	Procedure code identifying the specific service provided
ICD-10 code	Diagnosis code — what condition was treated
NPI	National Provider Identifier — your doctor’s national ID number

Your Statement Shows More Than You Owe — Why?

The “Billed Amount” on your statement is often higher than the “Amount Due.” If this seems confusing, here is a simple explanation:

• Billed Amount = What the provider originally charges (list price).
• Contractual Adjustment = Discount negotiated between the provider and your insurance company.
• Insurance Paid = What your insurer pays after applying the adjusted rate.
• Amount Due = What you actually owe.

Example:

• Doctor charges: $500 (Billed Amount)
• Insurance adjustment: -$200 (Contractual Adjustment)
• Adjusted amount: $300
• Insurance pays 80%: $240 (Insurance Paid)
• You owe: $60 (Amount Due)

You only need to pay the Amount Due. You do not have to pay the full Billed Amount.

What If Your Statement Doesn’t Match Your EOB?

Your insurance company’s Explanation of Benefits (EOB) should be similar to your provider’s billing statement. If you notice big differences between them, here’s what you can do:

1. Call your insurance company first and ask them to explain your EOB.
2. Next, call your provider’s billing office and ask them to check that the charges match what they sent to your insurance.
3. Ask for an itemised bill, which gives you a line-by-line breakdown of every charge.
4. You have the right to dispute any charge you believe is incorrect.

Frequently Asked Questions

Change Log

Date	Update
Sep 2026	The billing statement guide has been published and checked to make sure it matches standard provider formats.

Verified by Amala

Amala personally reviewed multiple medical billing statement formats linked to PayMyDoctor providers in 2026.

Last verified: Sep 2026
Questions? Contact Amala →

More PayMyDoctor Guides

• PayMyDoctor – Complete Patient Guide 2026
• PerYourHealth Guest Payment
• PerYourHealth Account Number
• PerYourHealth ID
• PerYourHealth Login
• PerYourHealth – Complete Patient Guide 2026
• Who Is Veradigm?