Page 16 - Work Force April 2016
P. 16
Understanding
Your Explanation
of Benefits (EOB)
Every time your dentist submits
a claim to the CSEA Employee Benefit Fund (EBF), we send you and your provider an Explanation of Benefits (EOB) letter that contains a lot of useful information.
To the right is an example of an EOB for a payment claim:
1 Your EBF ID number or subscriber ID: the number your provider should be using when submitting dental claim forms instead of your Social Security number.
2 The provider number and whether they participate in our dental plans
3 Date of service
4 Procedure description of services that were provided on this date
5 Fee submitted by your provider for procedure rendered
6 EBF allowance per your plan for procedure
7 EBF payment for procedure
8 Explanation why procedure is
denied per plan rules
9 For adjusted claims only. The previous payment would appear here.
10 Coordination of Benefits (COB). If you have a primary insurance, their payment would appear here.
We encourage you to review your EOB and verify that the procedures and all the information submitted is correct.
Questions? Contact CSEA EBF at 800-323-2732 and speak to a dental representative.
16 The Work Force April 2016
