EOBs: Alert! Missing Remittance Advice

The national class-action settlement agreements require that reason codes be on EOBs. The Horizon agreement is in effect and failure to provide the reason code violates the agreement. Members are urged to inform MSNJ of any Horizon plan EOBs that do not contain reason codes. Please write to info@msnj.org and put “Horizon: EOB Compliance Dispute” in the subject line. Please indicate the plan name and for how long the EOBs have been missing this information. If the EOBs contain inaccurate information, particularly about patient responsibility, please provide that information, too. We have learned that some of Aetna’s EOBs are dropping the reason code. It is not clear if this is an isolated situation. Please write to info@msnj.org if you receive EOBs that are missing the reason code. Please put: “Aetna: EOB remittance advice” in the subject line.

About MSNJ

Founded in 1766, the Medical Society of New Jersey is the oldest professional society in the United States. The organization and its dues-paying members are dedicated to a healthy New Jersey, working to ensure the sanctity of the physician–patient relationship. In representing all medical disciplines, MSNJ advocates for the rights of patients and physicians alike, for the delivery of the highest quality medical care. This allows response to the patients’ individual, varied needs, in an ethical and compassionate environment, in order to create a healthy Garden State and healthy citizens.

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