Highmark Discontinues Sending Certain EOB’s to Members

In an effort to avoid member confusion and support the environment, Highmark will no longer automatically mail paper Explanation of Benefits (EOBs) to members for provider-submitted claims if the services are covered in full or if all the member owes is a copayment.

Many of our clients have told us how confusing it can be to receive EOBs, when they do not owe money for services and no action is required on their part. This change will deliver an improved member experience and help members to avoid unnecessary confusion.

Implementation dates are as follows:

  • Fully-insured clients: May 9, 2016
  • ASO clients: July 15, 2016

DISCLOSURE

The information provided herein is intended solely for the use of our clients. You may not display, reproduce, copy, modify, license, sell or disseminate in any manner any information included herein, without the express permission of the Publisher or Publishers of articles within.

The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.