Coordination of Benefits Electronic and Manual Processing

You can view information on all the payers for EDI claims in the Coordination of Benefits Information (COB) window. The Coordination of Benefits Information window provides information on all payers for EDI claims. This includes primary, secondary, and tertiary payers for 837I, 837P, and 837D claims.

A summary of all COB activity by charge lines on an encounter for all previous transactions will display on the Coordination of Benefits Information window. When viewing COB1, COB2, COB 3, or All Payer data fields are editable by transaction line.

ERA File

When the ERA file contains a CAS segment with a charge line that has two identical reason codes, one CAS segment is created for the two identical reason codes in the 837 file. The reason codes are combined and display on a single line in the 837 file.

Example: The COB window contains CO45 $50 and CO45 $25 and a PR2 on a single service line, the CAS segment will create CAS*CO*45*75 in the 837 file to represent the CO45 amounts and continue to create the other CAS segments for the other reason codes reported.

Note: In COB claims, other insurance details are always populated with the payer details even though the service line is paid by the alternate payer.

Coordination of Benefits Electronic and Manual Processing

ERA File

Recommendations

Generating Electronic Secondary Claims from Manually Posted Primary Payments

Generating Secondary Electronic Claims

Access the COB Information Window

Enter the Allowed Amount in the COB Information Window

COB Electronic Claims Sub-Tab

COB Electronic Claims Sub-Tab

Coordination of Benefits Electronic and Manual Processing

ERA File

Generating Electronic Secondary Claims from Manually Posted Primary Payments

Generating Secondary Electronic Claims

Access the COB Information Window

Enter the Allowed Amount in the COB Information Window

COB Electronic Claims Sub-Tab

COB Electronic Claims Sub-Tab