Coordination of Benefits Form Direct Claim Form 2025

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For example, suppose you visit your doctor and get billed $250 for the appointment. Your primary health plan may cover the majority of the bill. Lets say, for example, thats $200. Then your secondary plan would pay the remaining $50.
Insurance companies coordinate benefits for a few reasons: To avoid paying twice for the same covered service. Duplicate payments could result in paying more than the service cost! To determine which plan is primary, which means the insurer pays for covered services first ing to the benefits provided by the plan.
To set up coordination of benefits, you will need to contact your insurance company. Your insurance company will ask you to fill out a form disclosing any other health plans you may have in place. To gather this information your insurance company may: send you a form in the mail.
About Coordination of Benefits COB claims are those sent to secondary payers with claims adjudication information included from a prior or primary payer (the health plan or payer obligated to pay a claim first). These claims can be sent 1) from provider to payer to payer or 2) from provider to payer.
This COB rule applies when a patient has two jobs, and they are enrolled in benefits packages at both jobs. Whichever plan they enrolled in first will be the primary insurance. Then, the insurance plan they enrolled in later with their second job would be the secondary insurance.
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