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Doctor sitting at computer

View Explanation of Benefits

Use this EOB tool — a faster, easier way to do business

EOB Tool

Get your daily lists of predeterminations and claim Explanation of Benefits (EOB) statements here – in an easy-to-use, searchable format.

This tool will enable you to receive your daily list of EOB statements online in PDF Format, 24 hours a day, 7 days a week and are available for up to 24 months.  You can either print the statements or save them to your computer.   You can perform searches by:

  • Claim, including predeterminations
  • Claim status, including finalized, in-process, pended, denied and rejected
  • Patient by name, date of birth, member ID, patient account and service
  • Payment, including date, check number/EFT trace number
  • Provider ID
  • Date range used in any search cannot exceed 31 days and not include the current date 

Within the tool you will also have access to:

  • View Claim Details
  • View PDF format of your paper EOB
  • Submit claim reconsideration online

EOB List
The EOB List screen provides a daily list and summary of EOB Statements for the previous business day

Search by Claim
This function allows you to search for an EOB Statement for a specific claim or claims.  Up to five (5) claim IDs can be entered per search or a date of service range can be entered.

Search by Patient
This function allows you to search for an EOB by patient with several options; patient’s last name, first name, and date of birth.  When searching for claims on SUBSCRIBER, you may use Member ID only OR First Name, Last Name and Date of Birth.  For claims on DEPENDENTS – you must use First Name, Last Name and Date of Birth

Search by Payment
Search by Payment allows you to search for an EOB by payment date or payment ID.  You can enter up to five checks or EFT trace numbers.

Search by Provider
This search allows you to search for an EOB at the servicing provider level by provider ID number.  You may search for up to five dentists.  For assistance with the provider ID number, select the DocFind link.  

By signing up for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) we will be able to eliminate paper predeterminations and EOBs and provide you with immediate access to your information.

Complete the form online, print and fax it to us. To complete your EFT enrollment, be sure to include a voided check or preprinted savings account deposit form.

 

Search Explanation of Benefits

Tips and troubleshooting

Reconciling EFT payments to your electronic EOBs

  • Use the “Search by Payment” tab.
  • The TIN should already be displayed, or you can select another TIN from the drop-down box.
  •  If you have access to view all EOBs, don’t select the PIN from the PIN field. Selecting the PIN will limit your search to the PIN selected.
  •  If your bank supplies the trace number/check number, you may enter up to five trace numbers/check numbers here. This is the most direct search option and will return the EOB you are looking for.
    - Example trace numbers — 813152410009999 (non-HMO) or 160601130099999 (HMO)
  • If you’re performing a search using the “Payment Date” span, be sure to enter a date range of at least five business days prior to the EFT deposit date to locate your EOB.
    - For example, if you are looking for a deposit dated /21/2013, your search criteria should be at least 7/15/2013 through 7/21/2013. The system will return all EOBs from the date span you’ve entered. You can’t search by just using the current date.
  • Once you’ve entered your search criteria, click the “Submit” button.
  • After finding your EOB, you can view, print or download it to your computer.

If you’re enrolled in ERA and we’ve started an overpayment recovery, you can use the Claim EOB Tool to get the patient information that corresponds to the recovery by retrieving that particular EOB.

If you need help with the Claim EOB Tool 
If you aren’t able to access all EOBs or only have access to partial EOBs, call the National Dentist Line at 1-800-451-7715 or the eTech Support Line at 1-800-225-3375. 

Or, use the Claim EOB Tool and click the “Contact Us” button in the upper right corner of the screen. Be sure to complete all of the required fields in the online form and then click “Submit.”

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