Insurance Eob Requirements Explained

Summary

Insurance companies are typically required to provide an Explanation of Benefits (EOB) after processing claims, whether approved or denied. If your insurer claims no EOB exists, request a formal written explanation and document all communications. You may also contact the Massachusetts Division of Insurance for further guidance. Reviewing your policy details or consulting with a regulatory body can provide additional clarity.

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health insurance did not send EOB after claim denial is this legal
Hey Danielle! In Rhode Island, insurance companies are generally required to provide an Explanation of Benefits (EOB) after a claim is processed, whether approved or denied. You might want to:
- Review your insurance policy for specific terms.
- Contact your insurer for clarification.
- Consider filing a complaint with the Rhode Island Department of Business Regulation if necessary.
Do you have any more details about the claim denial?
Claim denial is in massachusetts, went to hospital in rhode island, hospital sent bill late, kept losing my insurance information, I called multiple times never was informed they filed a claim and it was denied, I have no EOB or denial letter.
It sounds like a frustrating situation. Since the claim denial was in Massachusetts but the treatment was in Rhode Island, it might be beneficial to:
- Contact both your insurance company and the hospital for a clear explanation.
- Request a copy of the EOB from your insurance provider.
- Consider contacting the Massachusetts Division of Insurance for guidance on the denial.
Would you like assistance in connecting with a local attorney who can provide more personalized help with your case?
Insurance says there is no EOB
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It seems like you're facing a complex issue involving cross-state insurance claims. Since your insurance insists there's no EOB, you might want to:
- Request a formal written response from your insurance explaining their position.
- Document all communications with the insurance and hospital.
- Consider reaching out to both Rhode Island and Massachusetts insurance regulatory bodies for further guidance.
If you have any more details or need further assistance, feel free to ask!
Is it legal to not have an EOB
Case Rating: *
In general, insurance companies are required to provide an EOB for processed claims, whether approved or denied. However, requirements can vary based on state laws and policy terms. It may be beneficial to review your policy details or consult with a regulatory body. If you need further assistance, feel free to ask!