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Coordination of Benefits
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Re: Coordination of Benefits
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Steve Verno
Re: COB
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: 10924
Jan 25 07 8:17 PM
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My Recent Posts
The contracts I helped my doctors get were very specific about COB. The clauses basically stated that we do not get involved with COB issues, that is a patient and insurance responsibility. Any COB denials were billed to the patient. If the claim was in review due to COB, they had 30 days to resolve it and pay the claim.
The one huge problem I have is when the secondary denies the claim saying the primary paid more. My contracts spell this out because I quote Florida law which says that the combination of the primary and secondary cannot exceed the providers charges. So, my contract demands the carrier pay the balances if the service is covered.
When we are not contracted and they do this, I simply bill the patient. The patient calls and screams they are paying through the nose for insurance and I simply tell the patient their secondary never pays a claim, so why are they putting good money into this insurance company. That's when I get the "You want your money, you deal with my insurance company." No problemo - send one statement with a final notice warning and off to collections they go. When they call back I tell them I am not contracted and from now on they can send their own claim and pay me 100%. I hate to be thay way but I am when they act the way they do.
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Association News
Medical Billing & Coding Education from the MAB
Continuing Education
Management Advice and Training
Questions Asked More Than Once
Help Wanted - Billing and Coding
Non Billing Talk
The Venting Area (Clean posts please)
Medical Coding and Billing News
Fraud and Abuse
Health Insurance - Provider Contracting
ERISA
Tricare
Workers' Compensation
General Medical Billing Questions
Appeals
Accounts Receivables (A/R)
Refunds
Auto Accident Issues
Medisoft Technical Support
Medical Software Technical Support Questions Other than Medisoft. No Investigation Questions!
General Medical Coding Forum
CPT Coding Questions
HCPCS Coding Questions
ICD-9-CM Coding Questions
Evaluation & Management Coding Questions
Acupuncture Billing and Coding
Ambulance Coding and Billing
Cardiology Coding and Billing
Chiropractic Coding and Billing
Dental Billing and Coding
DME Coding and Billing
Emergency Department Coding and Billing
Family Practice Coding and Billing
Hospital Inpatient and Outpatient Coding
Hospital Billing, Appeals and Collections
Internal Medicine Coding and Billing
Laboratory Coding and Billing
Ophthalmology Coding and Billing
OB-GYN Coding and Billing
Pain Management Coding and Billing
Pediatric Coding and Billing
Podiatry Coding and Billing
Physical Therapy Coding and Billing
Psychiatry Coding and Billing
Radiology Coding and Billing
Surgery Coding and Billing
Neurology Coding and Billing
Urgent Care Coding and Billing
Provider Compliance
Billing Center Compliance
HIPAA
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Medical Association of Billers
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Coordination of Benefits
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