An agreement to prevent double payment for services when a subscriber has coverage from two or more sources. For example, a husband may be covered by Blue Cross and Blue Shield through work, and his wife may be covered by an HMO through her place of employment. The agreement determines which organization has primary responsibility for payment and which organization has secondary responsibility.
Coordination of Benefits. a method of integrating benefits payable for the same patient under more than one plan. Benefits from all sources should not exceed 100% of the total charges.
Coordination of Benefits. See Nonduplication of Benefits.
Coordination of Benefits. The determination of which of two or more plans or other third party payors are primarily or secondarily responsible for covered services provided to an enrollee. Such coordination is intended to preclude the enrollee from receiving an aggregate of more than one hundred percent (100%) of covered charges from all coverage. When the primary and secondary benefits are coordinated, determination of liability will be in accordance with the usual procedures employed by the California Department of Insurance and applicable state and federal regulations.
Coordination of Benefits. the process governing the payment of claims when you have a source of coverage in addition to TRICARE. Your other health insurance policy will pay for your benefits first; TRICARE coverage will be secondary.
Coordination of Benefits, or crossover.
Coordination of benefits. If the patient is covered under more than one insurance policy, the "coordination of benefits" principle states that he or she cannot collect payment amounts that total more than what was charged by the health care provider.
coordination of benefits. Method of integrating benefits payable under more than one health insurance plan so that the insured's benefits from all sources do not exceed plan benefit percentages and/or 100 percent of allowable medical expenses.
Coordination of Benefits. The provision which applies when an enrollee is covered by two health plans at the same time. The provision is designed so that the payments of both plans do not exceed 100% of the covered charges. The provision also designates the order in which the multiple health plans are to pay benefits. Under a COB provision, one plan is determined to be primary and its benefits are applied to the claim first. The unpaid balance is usually paid by the secondary plan to the limit of its responsibility. Benefits are thus "coordinated" between the two health plans.
Coordination of Benefits – The coordination of coverage between two insurance companies for one patient.
Coordination of Benefits. A system to eliminate duplication of benefits when a person is covered under more than one health plan; benefits under both plans are usually limited to no more than 100% of the Claim.
Coordination of Benefits. The health plan provision that determines the order in which benefits will be paid when an individual is covered under two medical insurance plans. This provision prevents double payment of benefits. Find this section in your contract.
Coordination of Benefits. The determination of primary, secondary, and tertiary insurer responsibility for a patient's health claim and the passing of claim and payment information between insurers.
Coordination of Benefits. A typical insurance provision whereby responsibility for payment for medical services is allocated between carriers when a person is covered by more than one health benefit program. This coordination avoids the possibility that a person will be reimbursed twice for the same services.
Coordination of Benefits. The mechanism used in group health insurance to designate the order in which the multiple carriers are to pay benefits and to prevent duplicate payments.
Coordination of Benefits. The provision that limits benefits for members with multiple benefits plans.
Coordination of benefits. In health insurance, policy provisions used by insurers to avoid duplicate payment for losses insured under more than one insurance policy (e.g., automobile or health) by making one of the insurers the primary payer, assuring that no more than 100% of the costs are covered and preventing the claimant from making a profit.
See Coordination of Benefits.
Coordination of Benefits. Provisions and procedures of insurers used to avoid duplicate payments when claims are covered by more than one insurance policy.
Coordination of Benefits. A process for determining the respective responsibilities of two or more health plans that have some financial responsibility for a medical claim.
provisions and procedures used by insurers to coordinate payment when there is more than one insurance policy to determine which is primary for payment.
Coordination of benefits. a provision under a group health plan that clarifies the order in which plans will pay if a given person has coverage under more than one plan.
Coordination of Benefits. Provisions and procedures used by insurers to avoid duplicate payments when a person is covered by more than one policy.
Coordination of Benefits. Provision regulating payments to eliminate duplicate coverage when a subscriber is covered by multiple group or pharmacy benefit plans. The procedures set forth in a Subscription Agreement to determine which coverage is primary for payment of benefits to Members with duplicate coverage. Used by insurers to avoid duplicate payment for losses insured under more than one insurance policy. A coordination of benefits, or "nonduplication," clause in either policy prevents double payment by making one insurer the primary payer, and assuring that not more than 100 percent of the cost is covered.
Coordination of Benefits. If the patient is insured under more than one plan (for example, the patient and the patient's spouse have family coverage from two different employers), COB determines which plan is responsible for which services and in what sequence the coverage will apply. COB is designed to eliminate duplicate coverage in these situations.
Coordination of Benefits. a provision in the contract that applies when a person is covered under more than one medical plan. It requires that payment of benefits be coordinated by all plans to eliminate overinsurance or duplication of benefits.
Coordination of Benefits. Involves a coordination of benefit payments for healthcare services provided to members who have more than one healthcare contract.
Coordination of benefits. When a member is covered under more than one group health plan or is receiving additional health care coverage, for example, that is related to a car accident or workers’ compensation, benefit payments are coordinated so duplicate payments for related services do not occur.
Coordination of Benefits. Rules that determine which insurance is to be billed first (primary) for services when patient is covered by more than one carrier. State and Federal guidelines apply.
Coordination of benefits. A method of coordinating reimbursements for health care treatment and supplies when you or a family member is enrolled in more than one health care plan — for example, medical and auto insurance or the Northrop Grumman plan and your spouseâ€(tm)s employerâ€(tm)s plan.
Coordination of Benefits. A provision in a contract that applies when a person is covered under more than one group health benefits program or other insurance. It requires that payment of benefits be coordinated by all programs to eliminate duplication of payments.
Coordination of Benefits. Method of integrating benefits payable under more than one health insurance plan so that the insured's benefits from all sources do not exceed 100 percent of allowable medical expenses or eliminate incentives to contain costs.
Coordination of Benefits. a procedure used by insurance companies to keep individuals from collecting more in benefits that was actually charged for services covered under more than one health insurance policy; no matter how many policies a person has, this provision limits the benefits that can be paid on each claim to 100 percent of the expenses covered; COB provisions also designate the order in which the multiple carriers are to pay benefits.
Coordination of Benefits. A provision designed to avoid duplicate payments or payments in excess of charges for benefits covered under more than one individual or group contract.
Coordination of Benefits. A policy provision permitting coordination of medical care benefits.
Abbreviation of coordination of benefits. When you are covered by more than one benefit plan, the two benefits are coordinated so that no more than 100 percent of the total covered expenses is paid. See " non-duplication of benefits" and " birthday rule."
Coordination of Benefits. Employees may be covered by two or more plans (theirs and their spouse/partner) at the time that services are rendered. COB is a method of integrating benefits under more than one group health insurance plan so that the insured's benefits from all sources do not exceed 100% of the allowable medical expense.
Coordination of Benefits. The process of using other insurance plans (families health plan, automobile or a third party's) to pay for the child's medical needs in full or in combination with CMDP.
Coordination of Benefits. A contractual provision to prevent an insured from receiving duplicate benefits from two or more group plans and profiting from over-insurance.
Coordination of Benefits. A group policy provision which helps determine the primary carrier in situations where an insured is covered by more than one policy. This provision prevents an insured from receiving claims overpayments.
Coordination of Benefits. A group health insurance policy provision designed to eliminate duplicate payments and provide the sequence in which coverage will apply (primary and secondary) when a person is insured under two contracts.
Coordination of Benefits. A mechanism allowing a Member covered by more than one health plan to potentially recover up to 100% of the billed amount of a claim. Generally, the primary (first) plan pays the greater amount, and the secondary plan pays the balance.
Coordination of Benefits. A provision in an insurance plan wherein a person covered under more than one group plan, has benefits coordinated such that all payments are limited to 100% of the actual charge or allowance. Most plans also specify rules whereby one insurer is considered primary and the other is considered secondary.
Coordination of benefits. A provision in an insurance plan that when a patient is covered under more than one group plan, benefits paid by all plans will be limited to 100 percent of the actual charge.
A typical insurance provision whereby responsibility for primary payment for medical services is allocated among carriers when a person is covered by more than one employer-sponsored health benefit program. This coordination prevents duplicate reimbursement for the same medical services.
The coordination of benefits (COB) rule applies in situations where a member (or dependent) is covered by both his/her own health insurance plan and another plan such as a spouse's insurer or Medicare. Under this rule, one plan is considered the primary payer and pays first, while the other plan is considered the secondary payer. Payment is coordinated under the COB rule to ensure that no more than 100% of any insurance claim is paid by all insurers.
Coordination of Benefits. COB applies if you or a family member is covered under another medical plan in addition to the coverage you have through AACPS. The benefits payable under you AACPS-sponsored coverage are coordinated with the other plan so that your total benefits from both plans will not exceed 100 percent of the benefit.
Coordination of Benefits. When the covered person is covered by another plan or plans, the benefits under the policy and the other Plan(s) will be coordinated so benefits from all sources do not exceed 100 percent of allowable expenses. This means one Plan pays its full benefits, then the other Plan(s) pay(s).
Coordination of Benefits – provisions made to avoid duplication of payments from more than one policy, in which one insurer is designated as the primary insurer over all others.
Coordination of Benefits. A typical insurance provision whereby responsibility for payment for medical services is allocated between carriers when a person is covered by more than one group health benefit program. Download a Coordination of Benefits form.
Coordination of benefits. An agreement using language developed by the National Association of Insurance Commissioners that prevents double payment for services when an insured has coverage from two or more sources. The agreement determines which organization has primary responsibility for payment and which has secondary responsibility.
Coordination of Benefits. A provision in the Certificate of Coverage requiring that, when an insured is covered under more than one medical plan, payment of benefits be coordinated between the medical plans in order to avoid duplication of benefits.
Coordination of Benefits. Provisions and procedures used by third-party payers to determine the amount payable to each payer when a claimant is covered under two or more group health plans.
Coordination of Benefits. Method of integrating benefits payments from all health insurance sources to ensure that payments do not exceed 100 percent of the covered healthcare expenses. Back to the top of the page
Coordination of Benefits. COB is a system which ensures that benefits aren't paid by other policies or plans. The Coordination of Benefits may also ensure that coverage will be provided in a specific sequence when more than one policy or plan covers the claim.
Coordination of Benefits. A way to integrate benefits payable under more than one health insurance plan that the insured may have. As a result, the benefits from all sources do not exceed 100% of allowable medical expenses or eliminate appropriate patient incentives to contain costs.
Coordination of Benefits. A term used when a member has medical coverage from two different sources and both parties share the cost. The COB department handles all insurance matters.
Coordination of Benefits. A process that determines which plan or insurance policy will pay first if two health plans or insurance policies cover the same benefits. If one of the plans is a Medicare health plan, Federal law may decide who pays first.
Coordination of Benefits. A provision that is intended to avoid claims payment delays and duplication of benefits when a person is covered by two or more plans providing benefits or services for medical, dental or other care or treatment. It avoids claims payment delays by establishing an order in which plans pay their claims and providing the authority for the orderly transfer of information needed to pay claims promptly. It may avoid duplication of benefits by permitting a reduction of the benefits of a plan when, by the rules established by this provision, it does not have to pay its benefits first. Refer to the Coordination of Benefits section of your applicable plan document.
Coordination of Benefits is a contract provision that prevents a policyholder from profiting by collecting from two different group plans such that the total collected is greater than actual expenses incurred. COB provisions provide for primary and secondary status for the various plans involved and seek to guarantee that the total paid by all will not exceed 100% of the out-of-pocket expenses of the claimant.
Coordination of Benefits. Used in group health insurance, this distinguishes the order that two or more insurance companies will pay benefits for the same claim.
