An EOB, Explanation of Benefit is a Legal Document

An EOB, Explanation of Benefit is a Legal Document

Everyone that posts dental insurance checks knows what an EOB is and how important that document is for explaining if and how the claim was paid and if the patient still owes any money on the claim.   The EOB has details that should be examined for accuracy because sometimes there are errors made by the insurance companies.
Storing of the EOBs is recommended in a safe HIPAA compliant fashion which is best by scanning the document into a computer file either in the patients chart or a master file within the computer document system.   Many dental offices still store these documents in paper form in a folder or file drawer which, unless locked, is not HIPAA compliant or safe from fire or other disasters.
The question is often asked as to how long these records should be stored?
General Recommendations. Cigna, a large health care insurance carrier, recommends that you keep EOBs for at least one year. The eXtension website, a service of public colleges and universities, recommends keeping the EOB for three to five years after the medical claim is paid in full.  There is a difference in answers here and the best answer would be found from calling the Dental Society of your state or contacting the American Dental Association. I have always kept them for three years and then shred them. If there is a complicated case or the patient is in a dispute over the dental treatment I would hold those for seven years.   
Proper credentialing and reporting the provider of services on claims will also be on the EOB.  This information will include the provider’s name, address, and tax ID number. If this information is not correct the practice should contact the insurance company and verify the credentialing information on file is accurate.  

 

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