Question

Explain the concept of coordination of benefits (COB) and provide an example. Cite any references used.

Answer 1

Co-ordination of benefits (COB)

It is the paln which provide the prescription coverage with medicare to a person. Sometimes a person will have two or more insurance plans which work togetherly to pay the claims for the same person.This process is called as co-ordination of benefits. Here the benefits indicates the medical claim payments and co-ordination indicates the collaborative work of two or more insurers to a same person.

The policy holder's benefits are depending upon the COB.The COB process helps for the fastest claim coverage to the policy holder.

According to co-ordination of benefits, the primary payer pays first and the pending amount will be payed by the second insurer.

The primary insurer will not provide 100% of the claim inorder to avoid the duplicate payment.

Eg: When any accidents or emergency situations occurs, the beneficiary goes to the hospital, clearing house, and the primary payer will pay the first and the secondary insurer will pay the second payment.

Referance:- intermountainphysician.org