DATE:

December 20, 2005

TO:

Carriers, Service Companies/TPA’s, Technical/Professional Review Entities, and Interested Parties

FROM:

Health Care Services Division

Due to privacy concerns and recent legislation regarding discontinuing the use of social security numbers on medical identification cards, the Health Care Services division is only requiring the last four digits of the injured worker’s social security number appear on the Explanation of Benefits (EOB) form (WCA-739).

Providers and carriers must still maintain each injured worker’s social security number as this information is required when filing any dispute or when providers file a 104B for purposes of proper identification.

With each technical/professional review methodology that is submitted to the Health Care Services division for approval, a sample EOB is required and it is expected that only the last 4 digits of the injured worker’s social security number will appear in that mandatory field.

For any further questions or clarification regarding the above information, please call the Health Care Services division at (517) 322-5433.