Quick payment with coordination of benefits
Coordination of benefits (COB) helps to determine which company is primarily responsible for payment. It occurs when a patient is covered under more than one insurance plan. This process lets your patients get the benefits they are entitled to. It also helps to avoid overpayment by either plan and gets you paid as quickly as possible.
When a patient comes to you, you can submit an eligibility and benefits inquiry. We will inform you if the patient is covered and which plan is primary.
There are two types of COB claims you can send electronically:
- Commercial insurance claims in which another payer is primary and Aetna is secondary
- Medicare primary claims for which Medicare* has not already forwarded their claims and payment information to us
When Aetna is secondary, you will need to include the appropriate code on your claim that tells us information about the previous payer's payment.
Contact the practice management support team and/or the clearinghouse you use to submit your electronic claims. They may have their own guidelines or tips about submitting COB claims.
*We can accept both Medicare Part A and Part B claims electronically from Medicare. If the Medicare electronic remittance advice (ERA) or Explanation of Payment (EOP) contains an "MA18" or "N89" remark code, the Medicare carrier has automatically sent us your claim. In these cases, you don't have to send us a Medicare primary COB claim.
We participate in COB SmartTM, a Council for Affordable Quality Healthcare® solution.
If you share our COB form with your patients, it will help you collect the data you need.