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New EOBs for Medicare Advantage Members

Beginning May 10, 2014, Blue Cross and Blue Shield of North Carolina (BCBSNC) will begin mailing Explanation of Benefits (EOBs) to members enrolled in BCBSNC’s Medicare Advantage products.  These new EOBs were designed based on requirements by the Centers for Medicare & Medicaid Services (CMS) and will offer our members detailed explanations about the claims we processed for them during a previous month, as well as show how their individual health care benefits were applied to the claim(s) in question.  

Receiving EOBs may be a change for our members, as BCBSNC has not issued EOBs to Medicare Advantage members in the past.  However, following a new CMS requirement, Medicare Advantage members will now begin receiving EOBs from BCBSNC.  To help members understand the new EOBs, they will also get an informational brochure with each EOB mailing.  

The EOBs that members receive in May will be for claims processed during April, and they will reflect visits to physicians, hospitals, and/or other health care providers.  However, if no claim was processed for a specific member during a previous month, an EOB will not generate as there is no claim activity to report. 

We want you to be aware of this change as your BCBSNC Medicare Advantage patients may bring in one of the new EOBs or mention it during an office visit.  If a patient has a specific question about the information on an EOB, please advise them to call BCBSNC at the customer service number listed on their member ID card.