How to Suppress Your Explanation of Benefits

Suppression of EOB

The suppression of EOB (Explanation of Benefits) process helps allow patients seek out health services privately and discretely.  An EOB is a statement that is often sent to prevent fraudulent activity and explains what types of services were billed for.  This is of particular importance to patients requesting mental health or reproductive health services.  For the CDTA outlined, the suppression of EOB process is important for patients under the age of 18 so that they could seek out the health services they need.  

Depending on the insurer an EOB may have information directly stating what type of service was rendered or they may be coded with billing codes so that the type of service is not revealed.  Some insurers cannot suppress EOBs and others may only send them if a balance remains.  The following list represents a range of common insurance providers with general guidelines on how to suppress sending these documents.

General approach in protecting your confidentiality from getting Explanation of Benefits being sent out to your house:

  • Call customer service: With your specific ID number and personal information, the customer service agent will explain what your current EOB notice option is, and will be able to offer you some options. The options are as following:
  1. Setting up an electronic (internet) account for your health insurance, and then opting out from getting mail: go paperless option
  2. Directing your separate address from your primary insurer: Most of the time, you would be using same household as your primary insurer, which is often your parents. Some plans may offer way to have EOB directed to a different address, so you may use a different address of someone that you trust.
  3. Building confidential communication request: this is the last resort. It’s an official and complicated legal process of blocking any kind of communication from the insurer to secure your information and safety. Some plans may not allow this to be used for this purpose (unless you have a safety concern from someone of

 

Private Insurers

Group Health Cooperative

888-901-4636 – Customer Service
206-901-4636 – Customer Service
206-448-2422 – Privacy Office

Method 1
1. Contact member services 888-901-4636 provide consumer ID number and request suppression of EOB or a confidential communication request.  A CSR will provide instructions on how to do this, you can only arrange this process by working with a CSR.
2. EOB will not be sent if balance is 0.
3. EOB will be sent mailed directly to patient.  
4. Legally, parents should NOT open their child’s mail.

Method 2
1. go to mygrouphealth -> click on go paperless
2. if the minor is under 13, the parent would have to set up the account
3. if the minor is over 13 they can set up their own account and select communication preferences

https://www1.ghc.org/static/pdf/public/customer-service/privacy-eng.pdf


Premera Blue Cross / Life Wise

877-266-7827 – Customer Service
800-722-1471 – Customer Service

  1. 14 or older’s minor information cannot be accessed from the parents
    The EOB will still be sent out to the primary insurer, but will have very limited information regarding the charge (just balance, general form of service received).
    The EOB can be requested to be sent out to the separate address specific to the person.
    Or, if the minor dependent registers online and declines the EOB mail service, it will only be accessbile via electronic (online) service.


Needs to talk to Customer Service to request suppression.  Depends on type of coverage.

https://www.premera.com/wa/visitor/privacy-policy/
https://www.lifewisewa.com/documents/011708.pdf

 

Regence blueshield WA

18883446347 – Customer Service

 

Regence blue cross = confidential communication.
1. EOB pharmacy claim without detailed  
2. Upon calling, the parent will have a full access to the information, if the dependent insurer is a minor.
3. If confidential communication form is turned in, within a few weeks, it will turn off everything. EOB and no calls, everything.
4. So, if the insurance holder calls to the call center and tries to figure out using the child’s personal info, they still have no way to refuse it: Upon receiving the form, they can put a private passcode for phone call access

https://www.regence.com/web/regence_individual/terms-of-use#notice-of-privacy-practices

Confidential Communication Form: https://www.regence.com/documents/10192/2507827/Confidential+Communication+request+form/def123b6-9d36-4f3f-965f-7eadbcdc889e?version=1.1

 

Medicaid Providers

Amerigroup WA

18006004441 – Customer Service


  1. As a medicaid insurance provider patients will not receive an EOB.
    This is because services would be covered by the insurance company.
    2.  In the event that a service is NOT covered, you would receive a notice
    directly from the provider’s office and you would have to ask for
    alternative notifications or complete suppression.

 

Community Health plan of WA

18004401561 – Customer Service


  1. As a medicaid insurance provider patients will not receive an EOB.
    This is because services would be covered by the insurance company.
    2.  In the event that a service is NOT covered, you would receive a notice
    directly from the provider’s office and you would have to ask for
    alternative notifications or complete suppression.

 

Washington Health Plan Finder

18005623022 – Customer Service

 

  1. As a medicaid insurance provider patients will not receive an EOB.
    This is because services would be covered by the insurance company.
    2.  In the event that a service is NOT covered, you would receive a notice
    directly from the provider’s office and you would have to ask for
    alternative notifications or complete suppression.

 

Molina healthcare of WA

18008697165 – Customer Service


  1. Molina will not be applicable to MOST patients under 18 years of age.
    2. Molina is more associated with L&I Workplace Injuries.
    3. For the most part workplace injuries would not cover reproductive health services

United Health care communitiy plan

18775428997 – Customer Service

 

  1. As a medicaid insurance provider patients will not receive an EOB.
    This is because services would be covered by the insurance company.
    2.  In the event that a service is NOT covered, you would receive a notice
    directly from the provider’s office and you would have to ask for
    alternative notifications or complete suppression.

 

Coordinated care of WA

18776444613 – Customer Service

  1. Patients will get explanation of benefits at the end.
  2. There’s no dependent insurer for Coordinated care. Everybody has their own ID number as an individual insurer.
  3. Accessing electronically to go “paperless” is a one quick way to suppress it.

 

http://www.hca.wa.gov/medicaid/publications/documents/22-542.pdf

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