Managing and Storing Paid Explanations of Benefits
One of the more common questions we get at our Help Desk is what to do with Explanations of Benefits (EOBs) for paid claims once the payment has been posted. Regardless of the payer class, whether personal injury, worker’s compensation, or simple commercial insurance, you have many choices and can select one that is best for your practice.
Having worked in Chiropractic practices in each of the last five decades, I can tell you I have seen it all. In the “olden days” of the eighties, you kept a copy of every check, and each was placed in the patient folder, stapled to the claim. I hesitate to think of how many trees gave their lives for this practice. Even worse, sometimes we got paid for multiple patients on one check and made the number of copies necessary and filed them in each folder! What a waste of time.
The more modern version of this is to post all the claims and zero pays for the day and compile them into a daily bundle at the end of the day. Any follow up needed on a particular payment is noted, and a working copy of that EOB is placed in your follow up folder. The day’s posting is then scanned into a computer file and filed by date in case you need to go back and reference that EOB later. You can correspond this date to the date the item was posted in your billing software and cross-reference it to any deposit slip that matches that date. It makes a great paper trail should anyone ever have to forensically follow the money.
These scanned daily items can be gathered by month and year in folders and backed up into your current backup system or stored in a secure online file. Remember, all these EOBs have Protected Health Information (PHI) and are subject to HIPAA restrictions, so please ensure the proper safeguards are in place for whatever folder these end up in.
Once the EOBs have been scanned by date, you can shred the originals. The working copies of any EOBs that require follow up are safely stored in your follow up folder and can be destroyed when you’re finished with them. One copy of a paid EOB, or a zero pay, is safely and securely stored by date.
Is this a compliance issue, or is there a real reason to keep paid EOBs?
It is not really a compliance issue, but frequently one must go back to an EOB and check to see if it was entered correctly or do some additional review or follow-up. Having them available electronically is ideal because they are there when you need them but not taking up physical space. You may set a process to purge a years’ worth of old copies annually, keeping, for example, only the most recent three years in your system.
Every office must make their own decisions about storage and records retention and ensure they have policies in place within their HIPAA program to outline procedures to be followed. No two offices are alike, and each office should scale these procedures to meet their needs.
If you have been storing physical copies in drawers or file boxes, consider the number of years you wish to keep the EOBs on file and shred the older ones. Perhaps a great project for an after-school helper would be to scan your physical copies to covert your system into years, months, and days for easy access. You won’t know what to do with all the file space you save!
Kathy Mills Chang is a Certified Medical Compliance Specialist (MCS-P), Certified Chiropractic Professional Coder (CCPC), and Certified Clinical Chiropractic Assistant (CCCA). Since 1983, she has been providing chiropractors with reimbursement and compliance training, advice, and tools to improve the financial performance of their practices. Kathy leads the team of KMC University specialists and is known as one of our profession’s foremost experts on Medicare, documentation and CA development. Kathy or any of her team members can be reached at (855) 832-6562 or info@KMCUniversity.com