To COB or not to COB…

What is COB?

Patients often ask this question after opening the mail and seeing a bill from their last office visit. There are a couple of ways to explain this to your patients but you should simplify the term as much as possible:

COB stands for Coordination of Benefits. Your insurance company probably sent you a form that they required you to fill out and return. What this form asks is if you have other insurances and if so which is primary. If this is not satisfied, your insurance company will not pay any of your claims.

There are some patients that are truly oblivious until ownership is left up to them. It is your billing manager’s responsibility to educate your patients and guide them on how to get their COB issues properly taken care of. Otherwise, your AR suffers and the patients get annoyed that the bill won’t pay itself!

Here are some misconceptions some patients may have when it comes to COB:

1) The insurance company will never know that I have another policy.

Guess what? There are databases that your insurance company has access to…that’s how they know you are insured by other policies!

2) I can pick which plan I want to be my primary plan.

Nope! You don’t determine which plan is primary, the birth month does. For example, if you have coverage by your spouse as well as your own policy, and your spouse’s birth month is January and yours is March, the primary plan will be your spouse’s. Your claim will not get paid if this is not communicated with both insurances.

3) My child has student insurance but that’s only if she’s in school, they won’t pay for anything. She’s covered under my plan, that’s the primary plan.

That is incorrect. The student insurance will always be primary. They must first deny the claim in order for the secondary to pay. If this is the case you must supply your office with the student insurance so that they can submit to them first.

It’s not what you say, but how you say it. In this case, it’s a little bit of both. If your staff is properly educated on the language that is used when talking to your patients, their trips to your office will be much less combative and more pleasurable. Let’s be ahead of the game!

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