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Healthcare Acronym: COB - Coordination of Benefits

July 27, 2012 1560 No of hits
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Healthcare  Acronym: COB - Coordination of Benefits

Coordination of Benefits refers to activities that are involved with the management, collection, and reporting of insurance coverage for those with Medicare. COB programs help consumers in identifying available healthcare benefits for Medicare beneficiaries. Once benefits and coverage have been found, the COB department coordinates the payment process to ensure there payments are not missed or misdirected. COB contractors do not process actual Medicare claims, however, nor do they field patient inquiries regarding claims. Medicare intermediaries remain responsible for many claim-specific issues.

Specific duties of a COB contractor include reporting changes in employment or insurance coverage, as well as reporting liability in no-fault automobile accidents or workers' compensation claims. Many COB contractors also typically field questions regarding Medicare Secondary Payers (MSPs), billing issues, processing claims, and accepting returns for misdirected Medicare payments.

For employees interested in learning more about COB contracting and the specifics of their Medicare-related coverage, it is recommended they ask questions regarding their employers' insurance policies. Group coverage through an employer (whether it be one's own or a spouse's) often necessitates learning about job-specific COB rules and coverage prior to the filing of a claim. Major classifications, such as whether coverage is granted by a primary or secondary provider, help an employee in determining the route to the best possible medical coverage.

Consumers are also advised to ask questions regarding their insurance policies. For example, when working for a company with multiple health insurance providers, which provider will pay for what kind of claims? It's crucial to know what proportion of one's insurance comes from each source, as well as what kind of coverage each individual provider offers. Family status is also central to many insurance providers because coverage scenarios can differ widely based on whether an employee is married, divorced, separated, or single. Employees with children should ask specific questions regarding provider policies toward dependents with health conditions.

There are also several guides on COB available for purchase. These will address COB with regard to Medicare, healthcare providers, and insurance providers, but questions regarding specific claims will still have to be directed toward individual providers. Consumers are also advised to obtain a working knowledge of claim settlement procedures.

Tags:   Healthcare Acronym: COB - Coordination of Benefits   COB   Medicare   Insurance   Employee   Coverage  

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Coordination of Benefits refers to activities that are involved with the management, collection, and reporting of insurance coverage for those with Medicare. COB programs help consumers in identifying available healthcare benefits for Medicare beneficiaries. Once benefits and coverage have been...

By: Richard Martine Created 75 months ago

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