Verify a coordination of benefits (COB) claim

While processing or entering a claim, if a prepaid amount is entered or changed during the save process a coordination of benefits verification runs. You'll need to review the COB information before you can proceed.

If you're reviewing the COB because of a pend code, click the Claim session tab to return to the claim and resolve the pend.

COB Field Descriptions

Field	Description
From Date*	The date of the other insurance coverage is in effect. Click and select a date or enter a date in `MM/DD/YYYY` format.
Thru Date	The termination date of the other insurance coverage.
Carrier*	The organization that issued the insurance policy. Select a carrier from the list.
Phone	The carrier's phone number. Enter any alphanumeric or non-alphanumeric characters.
COB Employer	The employer associated with the benefit plan offering. This is a free-form text field to show the employer, but there is no validation on spelling or verification the employer is in the system. This information won’t display anywhere else.
Comments	Additional information associated with the insurance coverage. Any comment text longer than 30 characters will wrap and show in the text box.
Group	The group or employer name. Enter any alphanumeric or non-alphanumeric characters.
Policy	The policy number for the healthcare coverage. Enter any alphanumeric or non-alphanumeric characters.
Plan Type	The claim benefit plan type (e.g. medical, dental or vision).
Level	The insurance plan order to pay the claim. The primary health insurance is the plan that pays the claim first, as if it were the only source of health coverage. Then, the secondary insurance plan picks up the cost left over after the primary plan has paid the claim. `P`—Primary `S`—Secondary `T`—Tertiary
Covered Dependents	The table lists each member of the family. `Name`—The name of the individual. `Relation`—The relationship to the dependent (e.g. Member, Spouse, Child). `Gender`—The individual's sex (M—male, F—female or U—unknown). Select unknown if you don't know the sex. Update the record once you do know. `Date of Birth`—The individual's birth date. `Covered`—A check mark indicates the individual is covered by this insurance policy. You must select at least one individual. Dual COB fields (displays based on system configuration) `Second ID`—The policy SSN for the secondary claim. If your system is configured for masking and is turned on, it will be masked. `Sec Depno`—The dependent number of the secondary covered dependent. When you enter the SSN into the `Second ID` field, the `Sec Depno` defaults to that dependent's number. `Auto-create`—Override automatic creation for a secondary claim. The claim will need to be processed manually
Review Information	Text that shows and the date and the operator ID of the person who last reviewed (clicked ), updated, or deleted the COB information.

Verify that the Coordination of Benefits information is correct according to your office's operating procedures.
Click to update the Review Information date and operator ID.
Click to apply the update.
After verifying the coverages, go back to the claim and resolve the edit by clicking the next edit arrow or use the F9 key.