Coordination of benefits (COB) is a reason why claims are “Denied.”

Coordination of Benefits (COB) is when a patient has more than one healthcare insurance company. The patient needs to call each insurance company to coordinate the benefits, i.e. which is primary or secondary. This a big reason for claims to be Denied or Take-backs from insurance. Insurance may also deny claims until the patient calls to confirm they have no other healthcare insurance.

Insurance will “deny” claims for coordination of benefits (COB)

How is Fixed?

• The provider or a representative from the office cannot solve this issue.
• Only the patient can solve this issue by calling the insurance company or “Member Services” on the back of the insurance card

When the patient has multiple healthcare insurances

• The patient must call the “Member Services” on the back of the insurance card for each insurance company
• In the call they are to inform the insurance company if they have any other “active” healthcare insurances
• If so, they must declare which one they wish to to primary and secondary
• Then the patient must call the second healthcare insurance to declare all insurances, along with declaring which is primary and secondary
• Have the patient notify the provider and the office to when the calls were placed to insurance, so that, you may follow-up on the claims to have them processed by the insurance
• The providers office, must confirm that they have the member ID information for all insurances. Ideally, the provider will have a copy of the insurance card for all insurances.
• After the primary claim has processed, the secondary claim may be submitted with proof of the adjudication of the primary claim(s)
• See video on submitting secondary claims to insurance