What’s happening
Today, when a claim denies for needing another insurance carrier’s payment information (EOB), we’re receiving the EOBs through a prism inquiry, asking for the claim to be reprocessed.
What’s changing
Effective May 5, 2026 we'll no longer accept an EOB attached to a prism inquiry for claim adjustment. If a claim is denied for needing the other payer’s information, providers must resubmit the claim electronically with the other insurance payment information included.
What this means for providers
When submitting claims electronically, be sure to include any other payer payment information to ensure proper reimbursement. Please be sure to update your internal billing processes to ensure all claims include this information.