Everything You Need to Know About Your Explanation of Payment

  • February 2, 2023

    Your Explanation of Payment (EOP) gives you information about the adjudication of your claims. Since EOP details vary by plan, we’re offering the grid below for clarification.

    The grid tells you where to find your EOPs by plan, where the payment comes from, check digit details, and when the payments are available.

     
      PAYMENT COMES FROM: CHECK NUMBER DIGITS: PAYMENT RUN DATES: LOCATED WITHIN AVAILITY
    Individual
    Evolent

    Payment and EOPs via Evolent Eagan, MN

    Electronic Funds Transfer (EFT) registration via InstaMed

    Electronic:
    8 digits

    Hard copy:
    8 digits

    		 Monday, Tuesday, Thursday, and Friday (ad hoc check runs on Wednesday – no check runs on the last 3 days of the month) No – view Evolent secure provider portal.
    Medicare Advantage
    Advantasure

    Payment and EOPs via several sources that pay claims:

    • Optum (behavioral health)
    • Dominion
      (dental)
    • Optum Care Network (Polyclinic, The Everett Clinic, Western Washington Medical Group)
    • Physicians of Southwest Washington
    • Seoul Medical Group
    • Non-delegated via Advantasure

    Electronic Funds Transfer (EFT) registration via Premera

    Electronic:
    Advantasure only:
    8 digits, starts with 5XXXXXXX

    Hard copy:
    8 digits, starts with 4XXXXXXX

    [CXE]

    Manual checks:
    8 digits, starts with 2XXXXXXX

    Important: We don’t have check information generated from delegates

    Wednesday

    Advantasure payments on Friday.

    OCN pays twice a week, PSW pays every week, unknown for SMG. We get encounters from these entities weekly.

    Note: Doesn’t include behavioral health and dental claims.

    		 No – view Advantasure secure provider portal.
    Commercial

    Premera Blue Cross and Premera Blue Cross Blue Shield of Alaska

    Electronic Funds Transfer (EFT) registration via Premera

    Electronic: 16 digits, starts with the year, i.e., 2023XXXXXXXXXXXX

    Hard copy
    10 digits, starts with 002XXXXXXX

    		 Saturday or last day of the month Yes
    FEP

    Blue Cross Blue Shield Federal Employee Program

    Electronic Funds Transfer (EFT) registration via Premera

    Electronic:
    10 digits, starts with 500XXXXXXX

    Hard copy:
    10 digits, starts with 400XXXXXXX

    		 Tuesday Yes
    Shared Administration

    Premera Blue Cross

    Checks and EOPs areonly available via hard copy; no Electronic Funds Transfer (EFT) option available

    		 Hard copy ONLY:
    9 digits, starts with 20XXXXXXX    		 Friday No
    LifeWise Assurance Company

    LifeWise Assurance Company (Premera affiliate)

    Electronic Funds Transfer (EFT) registration via Premera

    Electronic: 16 digits, starts with the year, i.e., 2023 XXXXXXXXXXXX

    Hard copy:
    10 digits, starts with 009XXXXXXX

    		 Saturday or last day of the month Yes
    Interest Payments Premera Blue Cross

    Hard copy ONLY: 9 digits,

    • PBC starts with 01XXXXXXX
    • PBCBSAK starts with 04XXXXXXX
    • LWAC starts with 08XXXXXXX

    PBC HMO starts with 09XXXXXXX

    Checks issued to:

    • Oregon providers: Saturday or last day of the month

    All other providers: Monthly (if applicable) - usually occurs mid to late part of the month.

    		 No

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