Companion to letter_request_eob.md. Sent from the patient's personal email account to the biller's billing email address (if one is on file). The email mirrors the certified letter so the biller has a record across both channels and cannot claim they were unaware the patient is gathering documentation.
Send the email same day as the certified letter goes out.
If no biller email address is available, do not send anything by email. The certified letter (with the biller cc'd in paper) is sufficient.
To: [BILLER BILLING EMAIL]
Subject: [PATIENT NAME], Account [PROVIDER ACCOUNT NUMBER], EOB requested from insurer, please hold collection activity
To whom it may concern,
I am writing to notify you that I have today mailed a certified
letter to [INSURER NAME] requesting the Explanation of Benefits for
the claim(s) you billed me on the bill referenced below. The EOB is
required for me to verify your bill against the plan's adjudication
before I pay or dispute.
Account / invoice number: [PROVIDER ACCOUNT NUMBER]
Patient: [PATIENT FULL NAME]
Date(s) of service: [DATE OF SERVICE RANGE]
Amount being billed: $[BILL BALANCE]
Statement date: [STATEMENT DATE]
I have also enclosed a copy of that certified letter to you as a
cc recipient by mail. This email is a courtesy duplicate so you have
an electronic record.
Two requests:
1. Please place a hold on any collection or credit-reporting activity
on this account while I gather the EOB and any itemized
documentation I need to verify the bill. This is a good-faith
dispute in progress; sending it to collections or reporting it as
delinquent during the dispute would constitute a violation of the
federal Fair Debt Collection Practices Act and, if the account is
for emergency services or ancillary services at an in-network
facility, of the No Surprises Act's protections.
2. If you can send me an itemized statement of the services you
billed (with CPT/HCPCS codes, dates, line-item charges) directly,
without waiting for the EOB, that would speed up the
reconciliation. I am requesting that separately by mail today as
well.
For any reply or to share documents electronically, please use:
Patient name: [PATIENT FULL NAME]
Phone: [PATIENT PHONE]
Email: [PATIENT EMAIL]
Mailing: [PATIENT MAILING ADDRESS]
Thank you for your cooperation.
Sincerely,
[PATIENT FULL NAME]All the same as letter_request_eob.md. The email body intentionally restates them so it can stand alone if the biller never receives the paper cc.