Add, update, or delete coordination of benefits information
When members and dependents have multiple insurance plans, you need to make sure they're making payments from the correct plans. Managing multiple plans under a single member or dependent is known as coordination of benefits (COB). See Coordination of benefits (COB) for more detailed information on COB plans.
If you have a claim reference number, a member or dependent name or number, or you received a claim with new or updated COB information, use the Coordination of Benefits tab to view, add, update, or delete information.
- Search and open the claim, member, or dependent.
- From either the
Patient
orClaims
menu selectCoordination of Benefits
.
Add a covered dependent for coordination of benefits
- On the Coordination of Benefits tab, click
below the table.
- Update the insurance information and select the coverage from and thru dates.
- Select the check box for each individual that has coverage in the
Covered Dependents
table. -
Click
to apply your changes.
-
Click
to save.
Update a COB entry
- Select the row to update.
- Make changes to the COB fields as necessary.
- If you’re offering employer-sponsored health benefits in your workforce, an employee of yours may qualify for what is called “dual insurance coverage” if her/his spouse is also receiving benefits from their respective employer (note: a child may also have dual insurance coverage if covered by both parents’ plans).
In such cases, the plan with the oldest policy holder is designated the “primary plan”, while the other is designated the “secondary” plan. The insurance carrier makes this designation, and it isn't selected by the employee making the claim. If needed, update any
dependents covered under the same insurance (dual COB).
- If you’re offering employer-sponsored health benefits in your workforce, an employee of yours may qualify for what is called “dual insurance coverage” if her/his spouse is also receiving benefits from their respective employer (note: a child may also have dual insurance coverage if covered by both parents’ plans).
In such cases, the plan with the oldest policy holder is designated the “primary plan”, while the other is designated the “secondary” plan. The insurance carrier makes this designation, and it isn't selected by the employee making the claim. If needed, update any
- Click
to apply your changes. The review date and operator name update.
-
Click
to save.
Delete a COB entry
- Select the row to delete.
-
Click
to delete the row from the table.
-
Click
to save.