COB & TIMELY FILING

Question 1

determines which carrier is primary and which carrier is
secondary for a claim
prevents duplicate payments,
underpayments, or overpayments

Answer 1

Coordination of Benefits (COB)

Question 2

pays the remaining balance if there are any

Answer 2

Secondary Payer

Question 3

this important to determine during the insurance verification process to avoid potential delays

Answer 3

Primary & secondary insurance designations

Question 4

Medicare uses this feature to expedite processing of claims that have more than one payer

Answer 4

Crossover claims

Question 5

has the authority to specify the primary plan of a child or dependent when both caretakers have health insurance

Answer 5

Court order

Question 6

it is when the organization is required to submit a claim to the insurance plan for services

Answer 6

Timely filing

Question 7

How long does the timely filing takes place?

Answer 7

typically 30 days to 1 yr

Question 8

Medicare & TRICARE has how long filing limits?

Answer 8

1 year

Question 9

Commercial plans has how long filing limits?

Answer 9

less than 1 year

Question 10

this helps to explain Medicare policies in an easy-to-understand format

Answer 10

Medicare Learning Network (MLN)

Question 11

they have the resources for coding & billing guidance

Answer 11

Medical Administrative Contractors (MAC)