CommercialAdministrativeMedium impact
Expanded Eligibility/Benefit Response for Coordination of Benefits Questionnaire
Medical Mutual of Ohio·OH·In the News
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Medical Mutual of Ohio is expanding their eligibility/benefit response system to notify providers when members haven't responded to required Coordination of Benefits questionnaires. Providers will receive a new status code (EB01-5 Active-Pending Investigation) indicating the member is active but claims may be delayed or denied if the COB questionnaire isn't completed within 45 days.
Action Required
No immediate action required - this is informational only. When receiving EB01-5 status codes during eligibility verification, ask patients to complete their Medical Mutual COB questionnaire to prevent claim delays. Monitor claims for members with pending COB status as they may be held for 45 days then denied if questionnaire is not returned.