Medical Billing Forum

Billing => Billing => : TXBiller January 10, 2019, 12:09:09 PM

: Who Pays First
: TXBiller January 10, 2019, 12:09:09 PM

Does anyone have a chart or an easy way of remembering who pays first?  I don't know why I find this so confusing for me.  For example:  Medicare vs BCBS or Aetna, etc.

I'm hoping there is a chart I can reference until I can get it memorized and understood.

TIA for any assistance you can give.  : )

: Re: Who Pays First
: Michele January 10, 2019, 12:59:33 PM

I personally do not have a chart but I found one on CMS.gov  https://www.medicare.gov/Pubs/pdf/11546-coordination-of-benefits.pdf 

I hope that helps.

: Re: Who Pays First
: PMRNC January 11, 2019, 09:53:56 AM

More than 90% of the time COB has already been established. The main problem is that many billers don't understand their are actually three different methods of COB a secondary can use to make payments.
If you contact the primary and secondary using good eligibility and benefits procedures you'll find the primary was already established. PMRNC also has a COB manual to help determine how payments and adjustments are posted using the three COB methods. You can find it in our store front at www.billerswebsite.com