We've gone through this exercise and have developed a draft table reflecting our take on the regulations - it is too big to post, but if you are interested, please let me know and I will be happy to forward it on to you individually - thx - b
Bill Bernath Blue Cross Blue Shield of North Carolina Privacy Office (919) 765-7006 [EMAIL PROTECTED] >>> "David Blasi" <[EMAIL PROTECTED]> 04/25/02 04:13PM >>> While this is a lengthy email, this issue has become a hot topic of dis cussion/review in workgroups in which we participate and we look forward to any comments that would assist our research as we work toward a resolution in this area. Thank you, Debra Maher Privacy Officer GEHA 816-257-5500 X4731 [EMAIL PROTECTED] -----Original Message----- From: David Blasi [mailto:[EMAIL PROTECTED]] Sent: Friday, February 01, 2002 8:48 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Privacy Question Re: EOBs/Checks Plan language and/or claims policy will help to clarify this issue. It depends on who the claimant is under the Department of Labor regulations and who the plan considers an authorized reReceived: from SLCDOM-MTA by firsthealtpresentative to be. For example, a plan may have a policy that the primary life is automatically an authorized representative for all covered dependents. Unless there is a QMCSO in place requiring the sending of information to a custodial parent and not to the non-custodial parent, you should be able to have language or policy that says the claimant is considered to be the provider or primary life (i.e. employee) and send EOB's to the appropriate addresses. This may change in COBRA situations because each person is considered a Qualified Beneficiary and in effect becomes the primary life, even if covered under a family type payment. Check withReceived: from SLCDOM-MTA by firsthealt your counsel on the specifics. >>> "Ken Hoover" <[EMAIL PROTECTED]> 02/01/02 07:49AM >>> Do all EOBs/checks for a spouse and/or legal age dependent have to be addressed to the spouse and/or legal aged dependent? My understanding is that the payor/administrator (TPA) would not have to issue EOBs/checks to the spouse and/or legal aged dependent because it is a payment. The one exception to this is provision � 164.522(b) regarding Confidential Communications. Your responses to this matter is very much appreciated. Thanks, Ken ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address.
