HIPPA Compliance clarification on Explanation of Benefits

[Guest Sherri Vernon]

What is the HIPPA compliance for Explanation of Benefits information,i.e., who should the EOB be addressed to? Should it always go to the employee or to individuals depending on who received the service? Could an over age dependent receive the EOB if no longer living with the employee?

[Guest JNH]

Did you ever receive any response to this question? Do you have any additional insight at this point? I am dealing with this very question and am interested to hear your thoughts. Thanks.

[Linda]

As far as I have been able to ascertain, many insurers (and insurers acting as TPAs of self-funded group health plans) are planning to continue to send the entire family's EOBs

to the named insured or covered employee. I am aware of the arguments for and against the practice (and there is support for both positions). But I think it is going to continue.

[Jbentz]

I think the the family EOB can still be used as long as it is stated in your Notice of Privacy Practices (NPP). They can always request a restriction and then the plan can decide whether to honor the request.